Role of remodeling of small diameter kidney arteries in the prognosis of progression of tubulointerstitial fibrosis in patients with chronic glomerulonephritis

Aim. To assess the role of remodeling of small diameter kidney arteries in the prognosis of progression of tubulointerstitial fibrosis in patients with chronic glomerulonephritis.

Material and methods. The study involved 97 patients with primary glomerulonephritis. The average age of patients was 37,27±1,2 years. The inclusion criterion was the presence of indications for renal biopsy. Renal biopsy was used to analyze renal tissue, in particular, for determining of tubulointerstitial fibrosis (TIF). Based on TIF sign, the patients were divided in 2 groups. The first group includes patients with TIF, the second — without TIF. Vasometry, a measurement of the renal arteries structures, was performed as part of renal biopsy. Parameters of internal and external diameters, wall thickness, intima, media, intima-media complex, vascular mass were analyzed.

Results. The influence of the size of the inner and outer diameters of the interlobular artery (MA) on the studied risk was established. Probability of TIF developing increases with decreasing of MA inner diameter (χ2-criterion =5,34, p=0,02) and increasing of MA outer diameter (χ2-criterion =7,77, p=0,005). Intimal thickness does not have a statistically significant effect on the risk of TIF developing (p=0,29), whereas media thickness has a high statistical significance in renal tissue remodeling (χ2-criterion =13,71, p=0,0002). A statistically significant effect of an increase in the vascular mass on the risk of TIF was determined (χ2-criterion =6,55, p=0,01).

Conclusion. We established that changes in the structure of small diameter kidney arteries in chronic glomerulonephritis occurs according to a hypertrophic type. Remodeling of small diameter kidney arteries plays significant role on the risk of TIF.

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