SIGNIFICANCE OF GLOMERULAR DEPOSITION OF PLASMIN-ALPHA2-PLASMIN INHIBITOR COMPLEXES IN VARIOUS GLOMERULOPATHIES

To elucidate the relationship between glomerular deposition of plasmin -alpha2-plasmin inhibitor complexes (PIC) and renal lesions or dysfunc tion, 25 patients with various glomerulopathies and various degrees of renal injuries were examined. Glomerular PIC deposition was found in eight patients (group A), and other 17 patients showed no deposition ( group B). PIC was found mainly in the mesangium and along the capillar y loops. Group A showed significantly more severe hematuria (p < 0.05) than group B. Group A showed a significant decrease in glomerular fil tration rate (GFR; p < 0.05): the mean values being 60.8 +/- 39 in gro up A and 94.5 +/- 32 ml/min in group B. Group A showed a significant d ecrease in the phenolsulfonphthalein excretion test (p < 0.05). There was no significant difference in the mean values of plasma PIC, D-dime r, and thrombin-antithrombin III complexes (TAT) between two groups. H istologically, group A showed a significantly high incidence of adhesi on (p < 0.05), crescentic formation (p < 0.05), endothelial swelling a nd/or detachment (p < 0.01), tubulointerstitial changes (p < 0.01), an d glomerular deposition of platelet factor 4 (p < 0.01). The present s tudy demonstrates that glomerular PIC deposition reflects the existenc e of activation of coagulation and fibrinolysis within the glomeruli a nd suggests that glomerular PIC deposition plays a part in the progres sion of renal injuries in various glomerulopathies.