Diffuse intermyocardiocytic fibrosis in patietns with chronic renal failure - a histomorphometric study
Marian Danielewicz, Małgorzata Wągrowska-Danielewicz, Ewa Rutkowska
Med Sci Monit 1996; 2(2): BR163-167
In 57 uraemic patients with end-stage renal diseases intermyo-cariocytic fibrosis was quantitatively evaluated at postmortem examination. The patients were divided into four groups: group A included 20 hypertensive patients with chronic glomerulonephritis, group B included 17 patients with diabetic nephropathy, group C included 10 hypertensive patients with renal amyloidosis group D included 10 nonhypertensive patients with renal amyloidosis. Patients with stenosing coronary lesions were excluded from the study. 20 specimens of heart tissue from non uraemic patients without coronary stenosis were used as a control group. Histological morphometry was performed by means of an image analysis system. The examination showed that diffuse non-coronary intermy-ocardiocytic fibrosis was significantly higher (approximately threefold) in all groups of uraemic patients in comparison with the controls. Significant differences were also found between uraemic hypertensive and nonhypertensive patients. However, they were not observed among groups A, B, and C. Strong correlations were noted between interstitial myocardial fibrosis and duration of renal failure as well as between interstitial myocardial fibrosis and serum creatinine level. The authors believe that diffuse non-coronary intermyoca-rdiocytic fibrosis is a morphological feature of uraemia, however, it is independent of the cause of renal failure. Hypertension has also been found to be an additional causative factor of interstitial myocardial fibrosis.
Keywords: intermyocardiocytic fibrosis, chronic renal failure