摘要：

The pathological changes in 50 percutaneous renal-biopsy specimens from patients with persistent glomerular nephritis have been analysed. Techniques were developed which allowed glomerular and tubular lesions to be assessed quantitatively. A highly significant correlation was found between the extent of tubular damage and creatinine clearance, plasma-creatinine, and the ability to concentrate and to acidify the urine. A less significant correlation was found between the extent of the structural changes in the glomeruli and creatinine clearance, plasma-creatinine, and the ability to concentrate the urine. In some patients with inconspicuous glomerular changes but severe tubular damage, the creatinine clearance was grossly reduced; conversely, in some patients with extensive glomerular changes but little or no tubular damage, the creatinine clearances were normal. It is concluded that in persistent glomerular nephritis the glomerular filtration-rate is more affected by changes in the tubules than by changes in the glomeruli. Degenerative changes in the renal arterioles tended to occur significantly more often with increasing age and with increasing diastolic blood-pressure. The severity of the structural changes in the glomeruli correlated significantly with the presence of hyaline arteriolar change; the extent of tubular atrophy correlated significantly with the presence of fibroelastic intimal hyperplasia.

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