Summary
Surgically removed perfusion-fixed human kidneys with chronic renal disease (hydronephrosis) were studied by electron microscopy in order to determine whether there is a quantitative relationship between ultrastructural changes in proximal tubules in atrophy and changes in the surrounding cortical interstitium. Morphometric techniques were applied to montages of electron micrographs each covering several tubular profiles in the cortical labyrinth and to montages representing cross-sections of individual proximal convoluted tubules at a higher magnification. In order to enable a quantification of the spatial relations between individual tubular cross-sections and adjacent peritubular capillaries a tubulo-capillary index (TCI) was defined. This index was based on the mean distances between individual tubular cross-sections and adjacent peritubular capillaries and on the fraction of tubular circumference facing capillaries. Normal tissue from similarly fixed human nephrectomy specimens, which had been removed mainly because of neoplastic disorders, served as control material. In the hydronephrotic kidneys the relative volume of cortical interstitium (excluding capillaries) covered a range from 19.2–70.3%. Inverse correlations were demonstrated between the relative volume of cortical interstitium and various structural variables of proximal convoluted tubules, including tubular wall volume, the volume of mitochondria and the surface area of basolateral membranes. The TCI showed positive correlations with these tubular variables. No significant correlation was found between the volume fractions of cortical interstitium and capillaries. Finally, it was found that an increase in the volume fraction of the cortical interstitium from 16.2% in controls to 24.7% in cortical areas of hydronephrotic kidneys was associated with a 40–50% reduction in the volume of mitochondria and in the surface area of basolateral membranes in proximal tubules. The results are consistent with a pathogenic interrelationship between tubular and interstitial changes. An important factor in this relationship might be disturbed topographic associations between tubules and blood capillaries caused by the increase in cortical interstitium. The results further show that even slight increases in the cortical interstitial volume are associated with significant quantitative changes in tubular fine structure suggesting impaired tubular functions.
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References
Bohle A, Thurau K (1974) Funktion und Morphologie der Niere im akuten Nierenversagen. Verh Deutsch Gesellsch Inn Med 80:565–582
Bohle A, Grund KE, Mackensen S, Tolon M (1977) Correlations between renal interstitium and level of serum creatinine. Morphometric investigations of biopsies in perimembranous glomerulonephritis. Virchows Arch [Pathol Anat] 373:15–22
Bohle A, Gise Hv, Mackensen-Haen S, Stark-Jakob B (1981) The obliteration of the postglomerular capillaries and its influence upon the function of both glomeruli and tubuli. Functional interpretation of morphologic findings. Klin Wochenschr 59:1043–1051
Bohman S-O, Maunsbach AB (1970) Effects on tissue fine structure of variations in colloid osmotic pressure of glutaraldehyde fixatives. J Ultrastruct Res 30:195–208
Christensen EI, Madsen KM (1978) Renal age changes. Observations on the rat kidney cortex with special reference to structure and function of the lysosomal system in the proximal tubule. Lab Invest 39:289–297
Christensen S, Ottosen PD, Olsen S (1982) Severe functional and structural changes caused by lithium in the developing rat kidney. Acta Pathol Microbiol Immunol Scand Sect A 90:257–267
Gise Hv, Gise Vv, Stark B, Bohle A (1981) Nephrotic syndrome and renal insufficiency in association with amyloidosis: A correlation between structure and function. Klin Wochenschr 59:75–82
Gottschalk CW, Mylle M (1956) Micropuncture study of pressures in proximal tubules and peritubular capillaries of the rat kidney and their relation to ureteral and renal venous pressures. Am J Physiol 185:430–439
Harris RH, Gill JM (1981) Changes in glomerular filtration rate during complete ureteral obstruction in rats. Kidney Int 19:603–608
Hestbech J, Hansen HE, Amdisen A, Olsen S (1977) Chronic renal lesions following long-term treatment with lithium. Kidney Int 12:205–213
Huland H, Leichtweiss H-P, Augustin HJ (1980) Changes in renal hemodynamics in experimental hydronephrosis. Invest Urol 18:274–277
Huland H, Gonnermann D (1983) Pathophysiology of hydronephrotic atrophy: the cause and role of active preglomerular vasoconstriction. Urol Int 38:193–198
Kappel B, Olsen S (1980) Cortical interstitial tissue and sclerosed glomeruli in the normal human kidney, related to age and sex. A quantitative study. Virchows Arch [Pathol Anat] 387:271–277
Kinn A-C, Bohman S-O (1983) Renal structural and functional changes after unilateral ureteral obstruction in rabbits. Scand J Urol Nephrol 17:223–234
Mackensen-Haen S, Bader R, Grund KE, Bohle A (1981) Correlations between renal cortical interstitial fibrosis, atrophy of the proximal tubules and impairment of the glomerular filtration rate. Clin Nephrol 15:167–171
Maunsbach A (1973) Ultrastructure of the proximal tubule: In: Orloff J and Berliner RW (eds) Handbook of Physiology, sect 8 Renal Physiology, American Physiological Society, Washington DC, pp 31–79
Møller JC, Skriver E, Olsen S, Maunsbach AB (1982) Perfusion-fixation of human kidneys for ultrastructural analysis. Ultrastruct Pathol 3:375–385
Møller JC, Skriver E, Olsen S, Maunsbach AB (1984) Ultrastructural analysis of human proximal tubules and cortical interstitium in chronic renal disease (hydronephrosis). Virchows Arch [Pathol Anat] 402:209–237
Nagle RB, Bulger RE, Cutler RE, Jervis HR, Benditt EP (1973) Unilateral obstructive nephropathy in the rabbit. I. Early morphologic, physiologic and histochemical changes. Lab Invest 28:456–467
Riemenschneider T, Mackensen-Haen S, Christ H, Bohle A (1980) Correlation between endogenous creatinine clearence and relative interstitial volume of the renal cortex in patients with diffuse membranous glomerulonephritis having a normal serum creatinine concentration. Lab Invest 43:145–149
Risdon RA, Sloper JC, deWardener HE (1968) Relationship between renal function and histological changes found in renal-biopsy specimens from patients with persistent glomerular nephritis. Lancet II:363–366
Schainuck LI, Striker GE, Cutler RE, Benditt EP (1970) Structural-functional correlations in renal disease. Part II: The correlations. Hum Pathol 1:631–641
Sloper JC, de Wardener H, Woodrow DF (1980) Relationship between renal structure and function deduced from renal biopsies. In: Leaf A, Giebisch G, Bolis L, Gorini S (eds) Renal Pathophysiology, Raven Press, New York, pp 109–120
Vaughan ED, Sweet RC, Gillenwater JY (1970) Peripheral renin and blood pressure changes following complete unilateral ureteral occlusion. J Urol 104:89–92
Weibel ER (1979) Stereological methods. Vol. 1 Practical methods for biological morphometry. Academic Press, London
Wilson DR (1972) Micropuncture study of chronic obstructive nephropathy before and after release of obstruction. Kidney Int 2:119–130
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This work was supported by grants from the Danish Medical Research Council (no 12-0528) and from the Research Foundation at the University of Aarhus
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Møller, J.C., Skriver, E. Quantitative ultrastructure of human proximal tubules and cortical interstitium in chronic renal disease (hydronephrosis). Vichows Archiv A Pathol Anat 406, 389–406 (1985). https://doi.org/10.1007/BF00710231
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DOI: https://doi.org/10.1007/BF00710231