J.Jpn. Surg. Soc.. 59(9): 1403-1430, 1958

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HISTOPATHOLOGICAL STUDIES ON THE ACUTE RENAL FAILURE PART 2. CLINICAL STUDIES

The series investigated comprises 32 patients with acnte renal failure with anuria or oliguria : hemorrhage (trauma, lobectomy etc.), incompatible blood transfusions, postoperative shock, peritonitis with shock, shock following dehydration (enteritis, cancer of stomch etc.), hepatorenal syndrome, various poisoning, sepsis and pneumonia.
The most important histological changes observed in the present material were as follows:
1) In acute renal failure fatty degeneration of Henle's loops is the first of all pathologic changes.
2) Degenerative and regenerative processes in the tubular epitheliuin, often present side by side.
3) Interstitial changes consisting in focal or diffuse with or without cellular infiltration of varying intensity and character.
4) Haemoglobin-pigmented casts in the distal convoluted tubules, Henle's loops, and collecting tubules.
5) Occasional dilatation of the tubules and low, flattened epithelium.
The present material suggested that the interstitial changes play a more dominant part than many previous workers attached to them.
The small amount of tissue available in the biopsy specimens naturally puts a certain limit to the value of the method in the case of lower nephron nephrosis. However, in the cases where a comparison was possible with the corresponding post mortem specimen, the biopsy method proved never to haye been misleading. We have found by the kidney biopsy method the fact that considerable functional impairment of the kidneys may be present with few or no pathological changes being demonstrable. (author's abstract)

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