Advertisement

Atubular Glomeruli in Chronic Renal Disease

  • N. Marcussen
Part of the Current Topics in Pathology book series (CT PATHOLOGY, volume 88)

Abstract

Quite different types of renal injury often lead to a common histopathological pattern. The histopathological changes that may be detected are interstitial fibrosis, glomerulosclerosis, and tubular atrophy. Even after the original etiological factor has ceased to act, the chronic renal disorders may continue to progress toward the end stage (KLahr et al. 1988). Several possible mechanisms responsible for progression and pathogenesis of chronic renal failure have been proposed. Some of these hypotheses have been limited to specific deseases while others have tried to cover all conditions leading to end-stage renal failure.

Keywords

Proximal Tubule Renal Artery Stenosis Chronic Renal Disease Tubular Atrophy Chronic Pyelonephritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Anderson RG, Bueschen AJ, Lloyd LK, Dubovsky EV, Burns JR (1991) Short-term and long–term changes in renal function after donor nephrectomy. J Urol 145: 11–13PubMedGoogle Scholar
  2. Bader R, Bader H, Grund KE, Mackensen-Haen S, Christ H, Bohle A (1980) Structure and function of the kidney in diabetic glomerulosclerosis. Correlations between morphological and functional parameters. Pathol Res Pract 167: 204–216Google Scholar
  3. Barajas L, Lupu AN, Kaufman JJ, Latta H, Maxwell MH (1967) The value of the renal biopsy in unilateral renovascular hypertension. Nephron 4: 231–247CrossRefGoogle Scholar
  4. Baxter TJ (1965) Cysts arising in the renal corpuscle. A microdissection study. Arch Dis Child 40: 455–463PubMedCrossRefGoogle Scholar
  5. Biber TUL, Mylle M, Baines AD, Gottschalk CW, Oliver JR, MacDowell MC (1968) A study by micropuncture and microdissection of acute renal damage in rats. Am J Med 44: 664–705PubMedCrossRefGoogle Scholar
  6. Bidani AK, Mitchell KD, Schwartz MM, Navar LG, Lewis EJ (1990) Absence of glomerular injury or nephron loss in a normotensive rat remnant kidney model. Kidney Int 38: 28–38PubMedCrossRefGoogle Scholar
  7. Bohle A, Bader R, Grund KE, Mackensen S, Neunhoeffer J (1977) Serum creatinine concentration and renal interstitial volume. Analysis of correlations in endocapillary (acute) glomerulonephritis and in moderately severe mesangioproliferative glomerulonephritis. Virchows Arch [A] 375: 87–96Google Scholar
  8. Bohle A, Mackensen-Haen S, von Gise H (1987) Significance of tubulointerstitial changes in the renal cortex for the excretory function and concentration ability of the kidney: a morphometric contribution. Am J Nephrol 7: 421–433PubMedCrossRefGoogle Scholar
  9. Bohle A, Gärtner H-V, Laberke H-G, Krück F (1989a) The kidney. Structure and function, 1st edn. Schattauer, Stuttgart, p 1Google Scholar
  10. Bohle A, Kressel G, Müller CA, Müller GA (1989b) The pathogenesis of chronic renal failure. Pathol Res Pract 185: 421–440PubMedGoogle Scholar
  11. Bohle A, Mackensen-Haen S, von Gise H, Grund K–E, Wehrmann M, Batz C, Bogenschütz O, Schmitt H, Nagy J, Muller C, Müller G (1990) The consequences of tubulo–interstitial changes for renal function in glomerulopathies. A morphometric and cytological analysis. Pathol Res Pract 186: 135–144Google Scholar
  12. Brenner BM, Meyer TW, Hostetter TH (1982) Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med 307: 652–659PubMedCrossRefGoogle Scholar
  13. Bricker NS (1969) Editorial: On the meaning of the intact nephron hypothesis. Am J Med 46: 1–11PubMedCrossRefGoogle Scholar
  14. Bricker NS, Fine LG (1981) The renal response to progressive nephron loss. In: Brenner BM, Rector FC Jr (eds) The kidney. Saunders, Philadelphia, pp 1056–1096Google Scholar
  15. Bricker NS, Morrin PAF, Kime SW (1960) The pathologic physiology of chronic Bright’s disease. An exposition of the “intact nephron hypothesis. ” Am J Med 28: 77–98PubMedCrossRefGoogle Scholar
  16. Bright R (1827–1831) A report of medical cases, selected with a view to illustrating the symptoms and cure of diseases by a reference to morbid anatomy, vol 1. Longmans, Rees, Orme, Brown and Green, LondonGoogle Scholar
  17. Burstone MS (1962) Enzyme histochemistry. Academic, New YorkGoogle Scholar
  18. Christensen S, Ottosen PD, Olsen S (1982) Severe functional and structural changes caused by lithium in the developing rat kidney. Acta Pathol Microbiol Immunol Scand [A] 90: 257–267Google Scholar
  19. Christensen S, Marcussen N, Petersen JS, Shalmi M (1992) Effects of uninephrectomy and highprotein feeding on lithium-induced chronic renal failure in rats. Renal Physiol Biochem 15: 141–149PubMedGoogle Scholar
  20. Cohen AH, Border WA, Rajfer J, Dumke A, Glassock RJ (1984) Interstitial Tamm-Horsfall protein in rejecting renal allografts. Identification and morphologic pattern of injury. Lab Invest 50: 519–525Google Scholar
  21. Couser WG, Stilmant MM (1975) Mesangial lesions and focal glomerular sclerosis in the aging rat. Lab Invest 33: 491–501PubMedGoogle Scholar
  22. Damadian RV, Shwayri E, Bricker NS (1965) On the existence of non-urine-forming nephrons in the diseased kidney of the dog. J Lab Clin Med 65: 26–39PubMedGoogle Scholar
  23. Evan AP, Tanner GA, Blomgren P, Knopp LC (1986) Proximal tubule morphology after single nephron obstruction in the rat kidney. Kidney Int 30: 818–827PubMedCrossRefGoogle Scholar
  24. Fischbach H, Mackensen S, Grund K–E, Kellner A, Bohle A (1977) Relationship between glomerular lesions, serum creatinine and interstitial volume in membrano-proliferative glomerulonephritis. Klin Wochenschr 55: 603–608PubMedCrossRefGoogle Scholar
  25. Franklin SS, Merrill JP (1960) The kidney in health; the nephron in disease. Am J Med 28: 1–7PubMedCrossRefGoogle Scholar
  26. Fries JWU, Sandstrom DJ, Meyer TW, Rennke HG (1989) Glomerular hypertrophy and epithelial cell injury modulate progressive glomerulosclerosis in the rat. Lab Invest 60: 205–218PubMedGoogle Scholar
  27. Gibson IW, Downie I, Downie TT, Han SW, More IAR, Lindop GBM (1992) The parietal podocyte: a study of the vascular pole of the human glomerulus. Kidney Int 41: 211–214PubMedCrossRefGoogle Scholar
  28. Gibson IW, More IAR, Lindop GBM (1993) Acquired glomerulocystic change in human kidney: a scanning electron microscope study. EDTA/EDTNA congress, Glasgow, p 23Google Scholar
  29. Grond J, Beukers JYB, Schilthuis MS, Weening JJ, Eleman JD (1986) Analysis of renal structural and functional features in two rat strains with a different susceptibility to glomerular sclerosis. Lab Invest 54: 77–83PubMedGoogle Scholar
  30. Gundersen HJG, Bagger P, Bendtsen TF, Evans SM, Korbo L, Marcussen N, Miller A, Nielsen K, Nyengaard JR, Pakkenberg B, Sfensen FB, Vesterby A, West MJ (1988a) The new stereological tools: disector, fractionator, nucleator and point-sampled intercepts and their use in pathological research and diagnosis. APMIS 96: 857–881PubMedCrossRefGoogle Scholar
  31. Gundersen HJG, Bendtsen TF, Korbo L, Marcussen N, Miller A, Nielsen K, Nyengaard JR,Pakkenberg B, Sørensen FB, Vesterby A, West MJ (1988b) some new, simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS 96: 379–394Google Scholar
  32. Heptinstall RH (1983) Pathology of the kidney. Little, Brown, Boston Heptinstall RH, Gorrill RH (1955) Experimental pyelonephritis and its effect on the blood pressure. J Pathol Bacteriol 69: 191–198CrossRefGoogle Scholar
  33. Heptinstall RH, Stryker M (1962) Experimental pyelonephritis. A study of the susceptibility of the hypertensive kidney to infection in the rat. Bull Johns Hopkins Hosp 111: 292–306Google Scholar
  34. Heptinstall RH, Michaels L, Brumfitt W (1960) Experimental pyelonephritis: the role of arterial narrowing in the production in the kidney of chronic pyelonephritis. J Pathol Bacteriol 80: 249–258PubMedCrossRefGoogle Scholar
  35. Heptinstall RH, Kissane JM, Still WJS (1963) Experimental pyelonephritis. Morphology and quantitative histochemistry of glomeruli in pyelonephritic scars in the rat. Bull Johns Hopkins Hosp 112: 299–311Google Scholar
  36. Hoedemaeker PJ, Weening JJ (1989) Relevance of experimental models for human nephropathology. KidneyInt35:1015–1025Google Scholar
  37. Hostetter TH, Olson JL, Rennke HG, Venkatachalam MA, Brenner BM (1981) Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. Am J Physiol 241 (Renal Fluid Electrolyte Physiol 10): F85–F93PubMedGoogle Scholar
  38. Hostetter TH, Rennke HG, Brenner BM (1982) Compensatory renal hemodynamic injury: a final common pathway of residual nephron destruction. Am J Kidney Dis I: 310–314Google Scholar
  39. Hostetter TH, Meyer TW, Rennke HG, Brenner BM (1986) Chronic effects of dietary protein in the rat with intact and reduced renal mass. Kidney Int 30: 509–517PubMedCrossRefGoogle Scholar
  40. Hostetter TH, Nath KA, Hostetter MK (1988) Infection–related chronic interstitial nephropathy. Semin Nephrol 8: 11–16PubMedGoogle Scholar
  41. Howie AJ, Gunson BK, Sparke J (1990) Morphometric correlates of renal exretory function. J Pathol 160: 245–253PubMedCrossRefGoogle Scholar
  42. Ivanyi B, Olsen TS (1991) Immunohistochemical identification of tubular segments in percutaneous renal biopsies. Histochemistry 95: 351–356PubMedCrossRefGoogle Scholar
  43. Ivanyi B, Olsen S, Marcussen N (1994) Tubulitis in primary vascular and glomerular renal disease, (submitted)Google Scholar
  44. Jacobsen NO, Jørgensen F, Thomsen Ac (1967) On the localization of some phosphatases in three different segments of the proximal tubules in the rat kidney. J Histochem Cytochem 15: 456–469CrossRefGoogle Scholar
  45. Jepsen FL, Mortensen PB (1979) Interstitial fibrosis of the renal cortex in minimal change lesion and its correlation with renal function. A quantitative study. Virchows Arch [A] 383: 265–270Google Scholar
  46. Kaplan C, Pasternack B, Shah H, Gallo G (1975) Age-related incidence of sclerotic glomeruli in human kidneys. Am J Pathol 80: 227–234PubMedGoogle Scholar
  47. Kappel B, Olsen S (1980) Cortical interstitial tissue and sclerosed glomeruli in the normal human kidney, related to age and sex. A quantitative study. Virchows Arch [A] 387: 271–277Google Scholar
  48. Klahr S, Purkerson ML, Harris K (1988) Mechanisms of progressive renal failure in experimental animals and their applicability to man. In: Davison AM (ed) Nephrology, vol II. Proceedings of the 10th international congress on nephrology. Bailliere Tindall, London, pp 1182–1191Google Scholar
  49. Koletsky S, Goodsit AM (1960) Natural history and pathogenesis of renal ablation hypertension. Arch Pathol 69: 654–662PubMedGoogle Scholar
  50. Kramp RA, MacDowell M, Gottschalk CW, Oliver JR (1974) A study by microdissection and micropuncture of the structure and the function of the kidneys and the nephrons of rats with chronic renal damage. Kidney Int 5: 147–176PubMedCrossRefGoogle Scholar
  51. Kumar S, Muchmore A (1990) Tamm-Horsfall protein—uromodulin (1950–1990). Kidney Int 37: 1395–1401PubMedCrossRefGoogle Scholar
  52. Lombet JR, Adler SG, Anderson PS, Nast CC, Olsen DR, Glassock RJ (1989) Sex vulnerability in the subtotal nephrectomy model of glomerulosclerosis in the rat. J Lab Clin Med 114: 66–74PubMedGoogle Scholar
  53. Lubowitz H, Purkerson ML, Sugita M, Bricker NS (1969) GFR per nephron and per kidney in chronically diseased (pyelonephritic) kidney of the rat. Am J Physiol 217: 853–857PubMedGoogle Scholar
  54. Mackensen-Haen S, Bader R, Grund KE, Bohle A (1981) Correlations between renal cortical interstitial fibrosis, atrophy of the proximal tubules and impairment of the glomerular filtration rat. Clin Nephrol 15: 167–171PubMedGoogle Scholar
  55. Mackensen-Haen S, Eissele R, Bohle A (1988) Contribution on the correlation between morphometric parameters gained from the renal cortex and renal function in IgA nephritis. Lab Invest 59: 239–244PubMedGoogle Scholar
  56. Mackensen-Haen S, Bohle A, Christensen J, Wehrmann M, Kendziorra H, Kokot F (1992) The consequences for renal function of widening of the interstitium and changes in the tubular epithelium of the renal cortex and outer medulla in various renal diseases. Clin Nephrol 37: 70–77PubMedGoogle Scholar
  57. Malt RA (1983) Humoral factors in regulation of compensatory renal hypertrophy. Kidney Int 23: 611–615PubMedCrossRefGoogle Scholar
  58. Marcussen N (1990) Atubular glomeruli in cisplatin–induced chronic interstitial nephropathy. An experimental stereological investigation. APMIS 98: 1087–1097PubMedCrossRefGoogle Scholar
  59. Marcussen N (1991) Atubular glomeruli in renal artery stenosis. Lab Invest 65: 558–565PubMedGoogle Scholar
  60. Marcussen N (1992) Atubular glomeruli and the structural basis for chronic renal failure. Lab Invest 66: 265–284PubMedGoogle Scholar
  61. Marcussen N, Jacobsen NO (1992) The progression of cisplatin-induced tubulointerstitial nephropathy in rats. APMIS 100: 256–268PubMedCrossRefGoogle Scholar
  62. Marcussen N, Olsen TS (1990) Atubular glomeruli in patients with chronic pyelonephritis. Lab Invest 62: 467–473PubMedGoogle Scholar
  63. Marcussen N, Ottosen PD, Christensen S, Olsen TS (1989) Atubular glomeruli in lithium–induced chronic nephropathy in rats. Lab Invest 61: 295–302PubMedGoogle Scholar
  64. Marcussen N, Ottosen PD, Christensen S (1990) Ultrastructural quantitation of atubular and hypertrophic glomeruli in rats with lithium-induced chronic nephropathy. Virchows Arch [A] 417: 513–522CrossRefGoogle Scholar
  65. Marcussen N, Christensen S, Petersen JS, Shalmi M (1991) Atubular glomeruli, renal function and hypertrophic response in rats with chronic lithium nephropathy. Virchows Arch [A] 419: 281–289CrossRefGoogle Scholar
  66. Marcussen N, Nyengaard JR, Christensen S (1994) Compensatory growth of glomeruli is accomplished by an increased number of glomerular capillaries. Lab Invest 70: 868–874PubMedGoogle Scholar
  67. Miller JC (1986) Dimensional changes of proximal tubules and cortical capillaries in chronic obstructive renal disease. A light-microscopic morphometric analysis. Virchows Arch [A] 410: 153–158Google Scholar
  68. Miller JC, Jøgensen TM, Mortensen J (1986) Proximal tubular atrophy: qualitative and quantitative structural changes in chronic obstructive nephropathy in the pig. Cell Tissue Res 244: 479–491Google Scholar
  69. Muehrcke RC, Kark RM, Pirani CL, Pollak UF (1957) Lupus nephritis: a clinical and pathologic study based on renal biopsies. Medicine (Baltimore) 36: 1–145Google Scholar
  70. Nyengaard JR (1993) The quantitative development of glomerular capillaries in rats with special reference to unbiased stereological estimates of their number and sizes. Microvasc Res 45: 243–261PubMedCrossRefGoogle Scholar
  71. Nyengaard JR, Marcussen N (1993) The number of glomerular capillaries estimated by an unbiased and efficient stereological method. J Microsc 171: 27–37PubMedCrossRefGoogle Scholar
  72. Ogata K (1990) Clinicopathological study of kidneys from patients on chronic dialysis. Kidney Int 37: 1333–1340PubMedCrossRefGoogle Scholar
  73. Oliver J (1939) Architecture of the kidney in chronic Blight’s disease. Hoeber, New YorkGoogle Scholar
  74. Oliver J (1950) When is the kidney not a kidney? J Urol 63: 373–402Google Scholar
  75. Oliver J (1953) Correlations of structure and function and mechanisms of recovery in acute tubular necrosis. Am J Med 15: 535–557PubMedCrossRefGoogle Scholar
  76. Oliver J, Bloom F, MacDowell M (1941) Structural and functional transformations in the tubular epithelium of the dog’s kidney in chronic Bright’s disease and their relation to mechanisms of renal compensation and failure. J Exp Med 73: 141–159PubMedCrossRefGoogle Scholar
  77. Olivetti G, An versa P, Rigamonti W, Vitali-Mazza L, Loud AV (1977) Morphometry of the renal corpuscle during postnatal growth and compensatory hypertrophy. A light-microscope study. J Cell Biol 75: 573–585Google Scholar
  78. Olsen TS, Wasssef NF, Olsen HS, Hansen HE (1986) Ultrastructure of the kidney in acute interstitial nephritis. Ultrastruct Pathol 10: 1–16PubMedCrossRefGoogle Scholar
  79. Olson JL, Heptinstall RH (1988) Nonimmunologic mechanisms of glomerular injury. Lab Invest 59: 564–578PubMedGoogle Scholar
  80. Olson JL, Hostetter TH, Rennke HG, Brenner BM, Venkatachalam MA (1982) Altered glomerular permselectivity and progressive sclerosis following extreme ablation of renal mass. Kidney Int 22: 112–126PubMedCrossRefGoogle Scholar
  81. Ottosen PD, Sigh B, Kristensen J, Olsen S, Christensen S (1984) Lithium-induced interstitial nephropathy associated with chronic renal failure. Reversibility and correlation between functional and structural changes. Acta Pathol Microbiol Immunol Scand [A] 92: 447–454Google Scholar
  82. Raaschou F (1948) Studies of chronic pyelonephritis with special reference to the kidney function. Munksgaard, CopenhagenGoogle Scholar
  83. Remuzzi A, Pergolizzi R, Mauer MS, Bertani T (1990) Three-dimensional morphometric analysis of segmental glomerulosclerosis in the rat. Kidney Int 38: 851–856PubMedCrossRefGoogle Scholar
  84. Risdon RA, Sloper JC, de Wardener HE (1968) Relationship between renal function and histological changes found in renal–biopsy specimens from patients with persistent glomerular nephritis. Lancet 2: 363–366Google Scholar
  85. Rosenbaum JL, Mikail M, Wiedmann F (1967) Further correlation of renal function with kidney biopsy in chronic renal disease. Am J Med Sci 254: 156–160PubMedCrossRefGoogle Scholar
  86. Schainuck LI, Striker GE, Cutler RE, Benditt EP (1970) Structural–functional correlations in renal disease, part II: the correlations. Hum Pathol 1: 631–641PubMedCrossRefGoogle Scholar
  87. Scherberich JE, Wolf G, Albers C, Nowark A, Stuckhardt C, Schoeppe W (1989) Glomerular and tubular membrane antigens reflecting cellular adaptation in human renal failure. Kidney Int 36 [Suppl 27]: S38–S51Google Scholar
  88. Seyer–Hansen K, Hansen J, Gundersen HJG (1980) Renal hypertrophy in experimental diabetes. Diabetologia 18: 501–505Google Scholar
  89. Seyer–Hansen K, Gundersen HJG, ©sterby R (1985) Stereology of the rat kidney during compensatory renal hypertrophy. Acta Pathol Microbiol Immunol Scand [A] 93: 9–12Google Scholar
  90. Shea SM, Raskova J, Morrison AB (1978) A stereologic study of glomerular hypertrophy in the subtotally nephrectomized rat. Am J Pathol 90: 201–210PubMedGoogle Scholar
  91. ShimamuraT, Heptinstall RH (1963) Experimental pyelonephritis. Nephron dissection of the kidney of experimental chronic pyelonephritis in the rabbit. J Pathol Bacteriol 85: 421–423Google Scholar
  92. Shimamura T, Morrison AB (1975) A progressive glomerulosclerosis occurring in partial five-sixths nephrectomized rats. Am J Pathol 79: 95–101PubMedGoogle Scholar
  93. Silva FG, Hogg RJ (1989) IgA nephropathy. In: Fischer CC, Brenner BM (eds) Renal pathology with clinical and functional correlations. Lippencott, Philadelphia, pp 434–493Google Scholar
  94. Smith HW (1951) The kidney. Structure and function in health and disease. Oxford University Press, New York, pp 872–878Google Scholar
  95. Smith SM, Hoy WE, Cobb L (1989) Low incidence of glomerulosclerosis in normal kidneys. Arch Pathol Lab Med 113: 1253–1255PubMedGoogle Scholar
  96. Sterio DC (1984) The unbiased estimation of number and sizes of arbitrary particles using the disector. J Microsc 134: 127–136PubMedCrossRefGoogle Scholar
  97. Tanner GA, Evan AP, Summerlin DB, Knopp LC (1989) Glomerular and proximal tubular morphology after single nephron obstruction. Kidney Int 36: 1050–1060PubMedCrossRefGoogle Scholar
  98. Tapia E, Gabbai FB, Calleja C, Franco M, Cermeno JL, Bobadilla NA, Perez JM, Alvarado JA, Herrara-Acosta J (1990) Determinants of renal damage in rats with systemic hypertension and partial renal ablation. Kidney Int 38: 642–648PubMedCrossRefGoogle Scholar
  99. Textor SC (1984) Pathophysiology of renovascular hypertension. Urol Clin North Am 11: 373–381PubMedGoogle Scholar
  100. Thurau K, Schnermann J (1965) Die Natriumkonzentration an den Macula densa–Zellen als regulierender Faktor fur das Glomerulumfiltrat ( Mikropunktionsversuche ). Klin Wochenschr 43: 410–413Google Scholar
  101. Tribe CR, Heptinstall RH (1964) The juxtaglomerular apparatus in scarred kidneys. An experimental study into the nature of the stimulus causing hyperplasia of the juxtaglomerular apparatus in rats. Br J Exp Pathol 46: 339–347Google Scholar
  102. Venkatachalam MA, Bernard DB, Donohue JF, Levinsky NG (1978) Ischemic damage and repair in the rat proximal tubule: differences among the SI, S2 and S3 segments. Kidney Int 14: 31–41PubMedCrossRefGoogle Scholar
  103. Walser M (1988) Progression of renal failure. In: Davison AM (ed) Nephrology, vol II Proceedings of the 10th international congress on nephrology. Baillere Tindall, London, pp 1155–1181Google Scholar
  104. Wehrmann M, Bohle A, Held H, Schumm G, Kendziorra H, Pressler H (1990) Long–term prognosis of focal sclerosing glomerulonephritis—an analysis of 250 cases with particular regard to tubulointerstitial changes. Clin Nephrol 33: 115–122PubMedGoogle Scholar
  105. Wood JE Jr, Ethridge C (1933) Hypertension with arteriolar and glomerular changes in the albino rat following subtotal nephrectomy. Proc Soc Exp Biol Med 30: 1039–1041Google Scholar
  106. Yoshida Y, Fogo A, Ichikawa I (1989) Glomerular hemodynamic changes vs. hypertrophy in experimental glomerular sclerosis. Kidney Int 35: 654–660PubMedCrossRefGoogle Scholar
  107. Yoshioka T, Shiraga H, Yoshida Y, Fogo A, Glick A, Deen WW, Hoyer J, Ichikawa I (1988) “Intact nephrons” as the primary origin of proteinuria in chronic renal disease. Study in the rat model of subtotal nephrectomy. J Clin Invest 82: 1641–1653Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • N. Marcussen

There are no affiliations available

Personalised recommendations