MORPHOLOGICAL ANALYSIS OF PATHOLOGICAL ALTERATIONS IN THE KIDNEYS DEPENDING ON DURATION OF ARTERIAL HYPERTENSION

THE AIM of the work was to study morphological alterations in the kidneys in patients with primary arterial hypertension (AH) at different stages of the  developing  process. PATIENTS AND METHODS. Under investigation there were  19  patients with AH in whom puncture nephrobiopsy was performed. Mean age of the patients was 33.4±12.6 years. Among them there were 11 men (57.8%) and 8 women (42.2%). Mean duration of primary AH was 5.5±4.5 years. The patients were divided into 3 groups according to the duration of AH. The first group included 7 patients with AH duration 1.4±0.6 years. Mean age of the patients was 28.7±10.2 years. The second group included 6 patients with AH duration 4.5±0.9 years, mean age 42.3±5.1 years. The third group consisted of 6 patients; duration of AH 11.3±3.1 years.  Mean age of the patients 40.2±8.8. RESULTS. Light optic microscopy has revealed in the 1st group alterations first of all in the interstitial tissue seen as periglomerular fibrosis. In the second group the morphological picture, the same as in the first one, was supplemented with thickenings and fibrosing of the walls of the arterial type vessels, proliferation  of the smooth  muscle  layer of arterioles,  signs of subatrophy and atrophy in the channels,  greater symptoms of hydropic and protein dystrophy in nephrothelium. In the 3rd group there were signs of sclerosing glomerules, hypertrophy of intact glomerules,  mild mesangial hypercellularity,  paramesangial hyalinosis,  marked periglomerular fibrosis,  plasmatic impregnation of the interstitium and walls of the arterial type vessels. CONCLUSION. So, the sequence of the involvement of kidney ultrastructures in the pathological process was established in AH patients, consisting in a paramount lesion of the tubular interstitial tissue, then vessels and finally - glomerules.

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