[Kidney involvement in liver diseases: morphology]

Abstract

Primary liver diseases are often associated with disturbance of the renal function, but only two hepatic lesions are due to glomerular changes: hepatitis B and alcoholic liver disease. Hepatitis B associated with immune complex glomerulonephritis seems to be a rare condition in adults, however children are more often involved. Glomerular changes consist of membranous deposition of immune complexes, mainly corresponding to membranous glomerulonephritis, seldom to the membranoproliferative type. Because membranous glomerulonephritis develops due to deposition of small size soluble complexes, and the hepatitis B antigens alone are estimated to be greater than soluble nephritogenic complexes, most probably low molecular weight antigenic components of the hepatitis antigens are involved in the formation of glomerulonephritis. Alcoholic liver disease is often combined with glomerulosclerosis and mesangial IgA deposition resembling the morphological pattern of IgA mesangial glomerulonephritis. These common features implicate a similar pathogenesis of both diseases. Furthermore, experimental and clinical data indicate raised serum levels of IgA and IgA deposition within glomerula and other organs in the same manner, but the cause of high serum levels of IgA remains still obscure, and may be different in both diseases.