[An evaluation of the relationships between the ionic and osmotic secretory capacities of the kidneys and interstitial medullary edema in patients with chronic glomerulonephritis].

Ion- and osmoregulatory capacity of the kidneys under induced water diuresis have been investigated in 100 patients with chronic glomerulonephritis (CGN) with reference to CGN clinical and morphological variants. An independent morphologist conducted a blind assessment of the results obtained at semiquantitative light morphometry of the renal medullary interstitial edema. According to an original formula, the morphometric index of the renal medullary edema was transformed into the index of the effective medullary edema (EME). The greatest EME occurred in CGN patients with nephrotic syndrome (NS). These patients and those with CGN and isolated urinary syndrome displayed inverse nonlinear relationship between EME and clearance of endogenic creatinine (Ccr), p < 0.05. In patients with CGN and NS, CGN and secondary arterial hypertension, membranoproliferative glomerulonephritis (MPGN), membranous glomerulonephritis (MGN) with NS advancing EME demonstrated association with decreased sodium or chlorine clearance. In groups with MPGN, MGN with NS a nonlinear relationship existed between EME and urea clearance. The findings suggest an important role of renal medullary edema in promoting disorders of renal filtration and ion-secretion capacity in CGN.