CONGESTED KIDNEY - SOME CHARACTERISTICS O F FUNCTIONAL-MORPHOLOGY

Kidneys of 56 patients who died at different stages of congestive hear t failure were studied with the use of hystologic and morphometric met hods. Kidneys of 10 healthy individuals of the same age succumbed in a ccidents served as control. The following features were characteristic of the ''congested'' kidney. 1) Increase in dimensions of juxtamedull ar glomeruli indicative of augmented filtration volume in juxtamedulla r nephrones which had high capability to reabsorb sodium and water. 2) Decrease of volume of glomerular capillary loops which was especially pronounced in cortical nephrones. This led to changes of intracapsula r and intratubular pressures and augmentation of tubular sodium reabso rbtion. 3) Increase of volume of nuclei in medullar collective tubules which was indicative of their overload (working) hypertrophy and augm ented reabsordtion of water. The magnitude of these changes depended o n the stage of heart failure. These changes could be present even in t he absence of clinical symptoms of heart failure when cardiac output w as only minimally decreased. The observed changes demonstrated that du ring development of heart failure kidney wored in the regime of antidi uresis and antinatriuresis (water and sodium retention).