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Extratubular efflux and nephropathy

The extratubular efflux of periodic acid‐Schiff (PAS) positive material is used as a histological indicator of intrarenal reflux, and correlation of the PAS positive material and interstitial as well as glomerular changes were analyzed in 114 surgical specimens consisting of renal calculi, hydronephrosis, vesicoureteral reflux, and others. (1) The incidence of extratubular efflux was apparently higher in the kidneys of hydronephrosis. (2) PAS positive material was seen not only in the interstitium but also flowed into the venous and lymphatic spaces. (3) Potent interstitial mononuclear cell infiltration and larger amounts of PAS positive material were seen in the kidneys showing a moderate grade of hydronephrosis rather than renal calculi. (4) Global glomerular sclerosis was the most frequent glomerular lesion, and segmental sclerosis and crescentic epithelial reaction in a small number of glomeruli were also noted. These results imply that intrarenal reflux could play an important role in the development of various renal tissue injuries.