The role of myofibroblasts and interstitial fibrosis in the progression of membranous nephropathy
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Data
2004-09-15
Autores
Rocha, Keyla B. F. [UNESP]
Soares, Vitor A. [UNESP]
Viero, Rosa Marlene [UNESP]
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Resumo
Renal interstitial fibrosis has been observed in a large number of nephropathies and contributes to the progressive deterioration of renal function. Myofibroblasts have been implicated in the reparative process of tissue injury, including renal scarring secondary to glomerular diseases. We performed a retrospective study on 28 patients with biopsy-proven primary membranous nephropathy, to determine whether interstitial myofibroblasts and tubulointerstitial lesions correlated with renal function at follow-up. Tubulointerstitial pathology was evaluated by morphometric and semiquantitative methods. Interstitial myofibroblasts were counted; 24-hour urinary protein and serum creatinine at the time of diagnosis and at the end of follow-up were available for all the patients. There were 20 males and 8 females, age 2-67 years (mean 42.3±153), most of them with nephrotic syndrome (78.6%). The final renal function had deteriorated in 16 patients (57.1%) and in 5 patients (17.8%) reached end-stage. The renal outcome was correlated with histological changes. We found a positive correlation between the severity of tubulointerstitial damage and the deterioration of the final serum creatinine (r 2=0.185; p=0.016). Myofibroblasts did not predict impaired renal function at the final follow-up. The current data do not support previous suggestions that myofibroblasts are a useful a predictor of end-stage renal disease.
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Palavras-chave
Chronic renal failure, Interstitial fibrosis, Membranous glomerulonephritis, Myofibroblasts, creatinine, adolescent, adult, aged, child, clinical article, controlled study, creatinine blood level, disease course, female, follow up, histopathology, human, human tissue, kidney biopsy, kidney failure, kidney fibrosis, kidney function, kidney interstitium, male, membranous glomerulonephritis, morphometrics, myofibroblast, nephrotic syndrome, prediction, priority journal, protein urine level, proteinuria, quantitative analysis, retrospective study, Adolescent, Adult, Aged, Child, Child, Preschool, Disease Progression, Female, Fibroblasts, Fibrosis, Follow-Up Studies, Glomerulonephritis, Membranous, Humans, Kidney Failure, Chronic, Kidney Tubules, Male, Middle Aged, Myoblasts, Retrospective Studies
Como citar
Renal Failure, v. 26, n. 4, p. 445-451, 2004.