Parenchymal destruction and arterial changes (haemodialysis intimal fibrosis) of glomerulonephritic kidneys in chronic intermittent haemodialysis.

The kidneys of 13 chronic diffuse glomerulonephritis patients who had been subjected to chronic intermittent haemodialysis were compared with those of 6 patients treated in the conservative way. Their renal parenchyma was examined with a semiquantitative histological method and advanced complete destruction of the glomeruli was demonstrated in the dialysed cases. There was no perceptive difference in the distribution of the various grades of damage of the recognizable glomeruli and tubules. With the exception of the chronic lobular glomerulonephritis cases, a marked obliterative mucoid intimal proliferation ("haemodialysis-intimal-fibrosis") had developed in the dialysed glomerulonephritis patients. It affected the renal arteries of all size from the segmental to the interlobular arties. Haemodialysis-intimal-fibrosis did not develop in the additionally examined 13 dialysed chronic pyelonephritis cases nor in 8 such treated conservatively. The change seems to be characteristic, but not specific, for chronic diffuse glomerulonephritis treated by chronic intermittent haemodialysis.