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Nephrol Dial Transplant (1992) 7: 373-378
© 1992 European Renal Association-European Dialysis and Transplant Association

other

Circumferential mesangial interposition: a form of mesangiolysis

Y. Nakamoto, T. Yasuda, H. Imai and A. B. Miura

Third Department of Internal Medicine, Akita University School of Medicine Akita, Japan

Correspondence and offprint requests to: Yasushi Nakamoto M.D., Third Department of Interl Medicine, Akita University School of Medicine, 1–1–1 Hondo, Akita, Akita 010, Japan.

A wide variety of glomerular lesions express circumferential mesangial interposition (CMI). The pathomorphogenesis of CMI involves low-grade mesangiolysis and subsequent passive dislocation of mesangial cells towards the lateral wall of glomerular capillaries through a high hydraulic pressure of blood flow penetrating the lytic mesangium. This is in contrast to the previous theories which advocate an active movement of mesangial cells. Moreover, circumferential mesangial interposition can disappear spontaneously or after treatment, suggesting that mesangial cells may return to the original site with their inherent contractility after the insults are removed, in order to restore handicapped filtering surfaces. But the precise mechanisms of its regression will be a subject for future investigation.

Keywords: circumferential mesangial interposition; double-contour structure; glomerular hydraulic pressure; membranoproliferative glomerulonephritis; mesangiolysis; microaneurysm


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