Histopathologic findings of bladder in chronic renal failure

Kim, Chang Soo; Chung, Sung Kwang; Chang, Sae Kook

Abstract

A variety or physical or functional changes are anticipated for the bladder in patients with chronic renal failure due to their long term exposure to many factors including uremia, oliguria, drugs and dialysis. We analyzed the histopathological changes of 10 bladders, from chronic renal failure patients who undergone renal transplantation, by H-E and Toluidine blue stain under light microscopic examination. The mucosa was thinned by a decreased layer of transitional cells; cellular swelling and mild inflammatory changes were noted. The submucosal layer showed inflammatory change, fibrosis, vasodilatation and infiltration of mast cells. Most marked changes were noted in the muscular layer by severe atrophy, fibrosis and fatty degeneration. Especially, marked atrophy or fibrosis was noted in patients with long term history of renal failure and marked fatty degeneration was noted in patients with anuria or oliguria. As a result, we concluded that the most significant changes the bladder suffered from chronic renal failure were atrophy or fibrosis of muscular layer. These changes should be of concern in performing ureteroneocystostomy and assessing restoration of normal voiding function in the recipient bladder. Afterward, more study about functional changes in these bladders will be needed to clarify completely the significance of chronic renal failure on the bladder.