Tubulo-interstitial changes in glomerulopathy. II. Prognostic significance.

In the first part of this report mechanisms that lead to the development of tubulo-interstitial changes in glomerulonephritis (GLN) were presented. This issue is of a great practical importance, since explaining renal function in GLN solely by glomerular parameters yields to unreliable and inconsistent results. When the prognosis is based on the glomerular lesions only, the risk of progression to chronic renal failure is often underestimated. In routine biopsy material occurs that no glomerular sclerosis is seen, although the clinical signs of renal failure are present. On the other hand, one can see advanced glomerular lesions, which are not necessarily associated with deteriorated renal function when no interstitial fibrosis is noted. Although in the light of the published reports these facts are not surprising, they are often neglected in everyday nephropathological practice.