Kidney Function and Histological Damage in Autopsy Subjects with Myocardial Infarction

Abstract

Objectives: Chronic kidney disease (CKD) is a major risk factor for cardiovascular disease (CVD). We previously reported renal parenchymal damage in autopsy subjects with stroke or abdominal aortic aneurysm. The aim of this study is to evaluate the relationship between renal histology and clinical characteristics of patients with myocardial infarction (MI). Methods: A total of 699 subjects were autopsied at the National Cerebral and Cardiovascular Center Hospital. We retrospectively evaluated all autopsy cases with MI (n = 123). Estimated glomerular filtration rate (eGFR) was calculated using the Japanese formula. Subjects were classified into four groups: 25 subjects with eGFR ≥ 60 mL/min/1.73 m 2 and no proteinuria (no CKD), 10 subjects with eGFR ≥ 60 and proteinuria (CKD1/2), 65 subjects with 60 > eGFR ≥ 30 (CKD3), and 23 subjects with eGFR < 30 (CKD4/5). Renal parenchymal damage was evaluated using a semi-quantitative histological score (score 0-3) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, arteriolar hyalinosis, and arteriosclerosis of medium-sized artery (maximum score = 15). Results: The mean histological score was significantly higher in patients with CKD3 and CKD4/5 and was associated with age, hypertension, diabetes, kidney function, proteinuria, and other CVD. Conclusions: In patients with MI, renal parenchymal damage and deteriorating kidney function are closely associated.

Shear wave elastography accurately detects chronic changes in renal histopathology

“…Kidneys that suffer histological damage show declining renal function 26 . Our study supports this statement with results showing that eGFR was significantly different between the different categories of histology.…”

“…Kidneys that suffer histological damage show declining renal function. 26 Our study supports this statement with results showing this increases renal cortical stiffness, which, in turn, increases YM measurements. 28 Our results also found that SWE imaging was able to distinguish between the <25% and 25%-50% groups, as well as between the <25% and >50% groups of interstitial fibrosis and tubular atrophy.…”

Angiotensin II Receptor Blocker Attenuates Intrarenal Renin-Angiotensin-System and Podocyte Injury in Rats with Myocardial Infarction

“…Accelerated and progressive decline in renal function is common and associated with increased mortality in MI patients during hospitalization [1,2]. Renal parenchymal damage is closely associated with deteriorating renal function following MI [3,4]. Therefore, it is of paramount importance to explore potential mechanisms involved in renal parenchymal damage in order to prevent the onset and progression of renal dysfunction after the initiation of MI with subsequent CHF.…”

Severe Intimal Thickening of Interlobular Arteries Revealed by a Renal Biopsy in an Adult with Prader-Willi Syndrome Complicated by IgA Nephropathy

“…However, the present patient had no hypertension or diabetes and was 31 years of age. Although considered in the autopsies of persons who died from myocardial infarction, histological changes (such as arteriolar hyalinosis and arteriosclerosis of medium-sized arteries) are strongly associated with the renal function and proteinuria (10).…”