ULTRASTRUCTURE OF HUMAN ACUTE-RENAL-FAILURE

  • 1 January 1982
    • journal article
    • research article
    • Vol. 46  (3) , 254-264
Abstract
With light microscopy, scanning electron microscopy and transmission electron microscopy 19 kidney biopsies from patients with oliguric and nonoliguric acute renal failure, 2 biopsies from patients with renal failure due to bilateral ureteral obstruction, and 15 biopsies with near normal tubules were studied. In acute renal failure, there were no intrinsic lesions of glomeruli, but lesions of varying severity were found in the proximal and distal tubules. Proximal tublar changes included diminished, bizarre or absent brush border, often with no or multiple cilia (often more severe in the straight segment of the proximal tubule); luminal surface blebs or bizarre projections; decreased, flattened or absent basal-lateral interdigitations simplified cuboidal appearance; bizarre lateral interdigitations; enlarged contracted attachment bodies; increased cytosomes, osmotic or autophagic; and decreased apical vacuoles. Distal tubule changes included decreased basal-lateral interdigitations of the convoluted segment, some decrease in microvilli, increased cytosomes and luminal casts, and enlarged contracted attachment bodies. These changes imply severe diminution of luminal and antiluminal surface area which may decrease Na and Cl flux and, might induce renal cortical vasoconstriction by tubuloglomerular feedback mechanisms. Tubular changes resulting from partial ureteral obstruction closely resembled those of acute renal failure.