Prediction of remodeling of arteries of kidneys of small diameter in patients with chronic glomerulonephritis

Abstract

Objective: to determine the significance of clinical, laboratory and morphometric indicators of structural restructuring of kidney tissue in the prognosis of remodeling of small-diameter kidney arteries in patients with primary chronic glomerulonephritis. Materials and methods: the study included 97 patients with primary chronic glomerulonephritis and indications for puncture nephrobiopsy. In all patients, anamnestic and clinical and laboratory risk factors were recorded, and nephrobiopsy was performed. When performing morphometric analysis of nephrobiopsy, the state of the tissue and vessels of the kidneys of small diameter was studied. To achieve this goal, all patients were divided into two groups, the ranking of which was carried out according to the median wall thickness of the interlobular artery. Results: Among all the risk factors studied, a statistically significant effect of an increase in the stages of hypertension (χ2 criterion = 4.24, p = 0.03) and a decrease in GFR (χ2 criterion = 5.92, p = 0.015) on the risk of increasing the thickness of the interlobular artery was found. The indicators of structural reconstruction of the renal tissue did not have a statistically significant effect on the likelihood of remodeling of the arterial wall. However, a direct correlation of weak strength was found between the severity of tubulointerstitial inflammation and the thickness of the wall of the interlobular artery (r = 0.23, p = 0.02). Conclusions: this work shows the paramount importance of hypertension, accompanied by damage to target organs, as a marker of remodeling of the vascular wall of the interlobular artery in patients with chronic glomerulonephritis.