In four renal biopsies of two patients with chronic glomerulonephritis (GN), the so-called dense deposit nephropathy (NDD) was diagnosed by means of light, electron, and immunofluorescence microscopy. In routine paraffin sections the picture approached that of the membrano-proliferative GN. In semithin sections (toluidine blue, periodic acid-Ag-methenamine) and especially in the ultrastructure there appeared extensive confluent deposits of a very dense substance, infiltrating the lamina densa of glomerular capillaries, basal membranes of both Bowman's capsules and tubules, and arteriolar walls. In this localization, a non-diffuse "psdudolinear" deposition of beta1c was detected, whereas antisera to main Ig-fractions and fibrin(ogen) were not fixed. In a biopsy performed six years later, a concentration of dense depositis towards the mesangial area and a partial regeneration of basal membranes were observed. In a part of dense deposits there appeared vacuolization, primarily in tubular and arteriolar basal membranes. In glomeruli, focal IgM deposits were apparent at an advanced stage. NDD apparently is a sequel of a particular metabolic (immune?) process, afflicting solely the renal membranous system and distinctly dns known at present. The noncharacteristic clinical presentation resembles chronic. GN, is very protracted, lengthy, and relatively benigh, with a chance of functional and possible even morphological remission.

Adult↗

PubMed1973

Focal and segmental glomerulosclerosis associated with the nephrotic syndrome: fine structure, pathogenetic aspects and clinical significance.

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Basement Membrane↗

PubMedDate not supplied

Urinary tract infection in renal transplant patients.

The incidence of urinary tract infections (UTI) in 299 renal graft transplantations (281 patients) was analyzed. UTI episodes were demonstrated in 185 grafts (62%), most frequently in the first month after transplantation. The infectious episodes were mostly recurrent. Persistent infection, detected in 11% of grafts, was associated with urologic complications in almost all cases. No significant correlation between the primary renal disease and the UTI rate was found, and there was no significant correlation between UTI and sex. In grafts with recurrent infectious episodes, vesicoureteral reflux was more common. No significant difference was observed in the residual bladder volume, irrespective of whether infection was present or not. The urine was infected by a number of hospital strains, particularly Klebsiella, Enterobacter and indole-positive Proteus strains. An overwhelming majority of UTI episodes (96%) were asymptomatic. Antibody-coated bacteria in urinary sediment were present in only 19% of infectious episodes. Clinically severe courses were observed in infections associated with urologic complications (especially urinary fistulae); these were difficult to treat and were often a source of sepsis and a risk factor in graft loss.

Adolescent↗

PubMedDate not supplied

[Focal segmental glomerulosclerosis].

Focal and segmental glomerulosclerosis accounted for 4.1% of all primary glomerulopathies. Typical signs of focal and segmental glomerulosclerosis were striking arteriolosclerosis on histological examination, the urinary syndrome of high proteinuria with mild haematuria and frequent nephrotic syndrome. The ten-year cumulative percentage of remissions was 30%. Patients with remission had at the time of biopsy a normal serum creatinine level and no or minimal regressive tubulointerstitial changes. The ten-year cumulative percentage of renal failure was 40%. Presence of nephrotic syndrome, extracapillary proliferation and advanced tubulointerstitial changes, tended to shorten a kidney survival. In one third of the patients the serum creatinine level rose by more than 50 mol/1/year.

Adult↗