ENLARGEMENT OF HEMODIALYZED SPLEEN IN UREMIA—HISTOPATHOLOGICAL AND BIOMETRICAL STUDIES COMPARED WITH THE KIDNEY

Abstract

Thirty‐three cases of uremia receiving hemodialysis as a study group and 9 cases of chronic glomerulonephritis without hemodialysis as a control group were selected from 1415 autopsy cases at this department for histopathological examination. Crystal and calcareous deposits, arteriolar findings similar to malignant nephrosclerosis, so‐called ‘specific arterial changes’ and disappearance of compensatory tubular hypertrophy were predominantly observed in the hemodialyzed kidneys. Hemodialyzed spleen seemed to be enlarged independently from the term or number of hemodialysis program. Histological examination of the spleen showed marked atrophy of the white pulp and marked congestion with pulp hyperplasia of the red pulp without crystal and calcareous deposits or arteriolo‐arterial changes as those seen in the hemodialyzed kidneys. In the prolonged hemodialyzed cases the reconstruction of the red pulp with hyperplasia of the pulp and sinus was predominantly observed. Biometrical examination revealed enlargement of hemodialyzed spleen resembling the cardiac congestive spleen in regard to the findings of the red pulp. Enlargement of the hemodialyzed spleen is likely to be caused by pulp and sinus hyperplasia with the reconstruction of the red pulp following chronic systemic congestion accelerated by procedure of hernodialysis superimposed on chronic renal failure.