Cortical and medullary vascularity in renal allograft biopsies

Authors: ŞADİYE MEHTAT ÜNLÜ, ALİ ÇELİK, FUNDA SAĞLAM EYİLER, SİBEL ERSAN, SÜLEN SARIOĞLU

Abstract: Aim: To evaluate the relation between cortical and medullary peritubular capillaries (PTCs) and scarring. There are presently no studies about medullary PTCs in renal allograft biopsies. Materials and methods: Nonprotocol allograft biopsies were evaluated and 41 with adequate medullary and cortical tissues were selected. Vascular structures were counted separately at the medulla and cortex on anti-CD34 stained sections. Other histopathological and clinical findings were retrieved from the patient files. Results: A weak but positive correlation was found between the number of cortical vascular structures (nVC) and medullary vascular structures (nVM). The nVC and nVM were decreased in cases with increased renal scarring; however, this was not statistically significant. A moderate negative correlation was found between nVC and blood creatinine (Cr) at the time of biopsy (P = 0.045, r = -0.32), but not between nVM and Cr. A moderate negative correlation was detected between both nVC and nVM and the most recent Cr (P = 0.01, r = -0.54 and P = 0.03, r = -0.51). Conclusion: nVC might be a valuable prognostic marker, as described previously. The relation between the latest Cr and nVM suggests that nVM might also be of value, a novel finding requiring further investigation. The weak correlation between nVC and nVM, which is described here for the first time, may point to unequal responses of the cortex and medulla to injurious factors.

Keywords: Peritubular capillaries, medulla, renal allograft

Full Text: PDF