Nephrogenic Diabetes Insipidus A Study of the Fine Structure of the Kidney in a Seven-Month-Old Male

Abstract

This is the first description of the fine structure of the kidney in nephrogenic diabetes insipidus. Striking changes were found throughout the entire kidney. In both proximal and distal tubules, mitochondria contained concentric ringed structures, and many mitochondria had myelin figures associated with their outer membranes as seen in figures 6-13. In figure 9, the intramitochondrial body is seen to be deforming the outer mitochondrial membrane, and in figure 7, it is shown to be continuous with this membrane. Gristae were virtually absent in the areas where the concentric ringed structures are found. There was a disruption of the mitochundrial architecture with formation of the ringed bodies which may be the precursors of the myelin figures. In addition to the tubular changes, the glomerular ultrastructure had a predominately fetal configuration which would seem to be unusual in a seven-month-old infant. SpeculationThe alteration in mitochondrial membranes should be correlated with enzymatic studies in this and other tubular disorders. It might then be ascertained whether these mitochondrial changes can be related to the decrease in content of 3' -5' cyclic AMP.