[Comparative evaluation of the clinical course and dynamics of the morphological changes in chronic glomerulonephritis]. / Sravnitel'naia otsenka klinicheskogo techeniia i dinamiki morfologicheskikh izmenenii pri khronicheskom glomerulonefrite.

The results of a simultaneous study of a clinical and morphological course of chronic glomerulonephritis (CGN) in 30 patients after repeated morphological investigation of the renal tissue showed that a prevailing tendency in this disease was the progression of morphological changes which could be noted in a stable clinical picture and even in clinical improvement. The detection of tubulointerstitial changes in the first nephrobiopsy was an unfavorable prognostic factor. Of the greatest importance for indirect assessment of a morphological course of CGN were changes in creatinine clearance, effective renal plasma flow and arterial pressure. A morphological course of different variants of CGN and the effect of pathogenetic therapy on it were analyzed.

[Tubulointerstitial component of chronic glomerulonephritis. Clinico-morphological comparisons]. / Tubulo-interstitsial'nyi komponent khronicheskogo glomerulonefrita. Kliniko-morfologicheskie sopostavleniia.

A total of 179 patients with chronic glomerulonephritis were examined for the development of the tubulo-interstitial component (TIC) of the disease. It was established that the rate of the development and intensity of the TIC are linked with different morphological variants of GN and increase successively in mesangiomembranous, membranous, mesangioproliferative, mesangiocapillary (and lobular) GN, reaching a maximum in diffuse fibroplastic GN. In patients with no TIC, the hematuric and latent forms of CGN were mostly encountered. The disease took a stable course, with a frequent occurrence of improvements and remission. The 5-year survival was 100%. In patients with a moderate TIC, the nephrotic form of CGN was encountered more often than in other patients. As regards other characteristics, this form occupied an intermediate position, with the 5-year survival rate amounting to 91%. Patients with a pronounced TIC were marked by progressive CGN, which was largely observed in the hypertonic and mixed patterns of the disease. The three-year survival amounted to 34% in this case. The TIC of CGN is an important prognostic factor and the dissimilar course of different morphological variants of CGN is accounted, to a considerable degree, for by the dissimilar rate of TIC development.