A clinicopathological study on acute renal failure - Histochemical and immunoenzyme-histochemical analysis -

This study was performed to determine whether disseminated intravascular coagulation (DIC) contributes to the pathogenesis of acute renal failure. Based on clinical feature informations including laboratory tests, 73 cases were selected from among 3, 769 cases autopsied between 1969 and 1984 at Okayama University Medical School and Himeji Red Cross Hospital. The 73 cases were composed of 66 cases of clinically diagnosed acute renal failure and 7 cases without renal failure serving as controls. The renal tissue sections stained by histochemistry (PTAH) or immunoenzyme-histochemistry (Fibrinogen, FDP-D and-E) were examined in order to detect Fibrin-Related Materials (FRMs) in the glomerular capillaries and tubuli. Microscopic observation revealed that the staining intensity of FRMs by immunoenzyme-histochemistry was much greater than that by histochemistry, but no marked difference existed between Fibrinogen and FDP in that regard. FRMs were negative in all control cases. In contrast, FRMs were positive in 59 cases (89.4%) of acute renal failure, though FRMs were detected in the glomeruli only in 8 cases (12.1%), tubuli only in 20 (30.3%), and in both the glomeruli and tubuli in 31 cases (47%). These results sugessted that DIC contributes pathophysiologically to the induction of acute renal failure.