Diffuse intermyocardiocytic fibrosis in uraemic patients

Nephrol Dial Transplant. 1990;5(1):39-44. doi: 10.1093/ndt/5.1.39.


At post-mortem we examined heart tissue of (i) 31 patients with uraemia not on dialysis, (ii) 42 patients on haemodialysis for less than 6 months, (iii) 60 patients on haemodialysis for more than 6 months, (iv) 16 patients after renal transplantation, and (v) 11 patients on CAPD. Patients with stenosing coronary lesions were excluded. Diffuse non-coronary intermyocardiocytic fibrosis, assessed by a score system in trichrome-stained sections, was found in 91% of chronically uraemic patients, but not in non-hypertensive, non-diabetic controls. The lesion was present even in non-dialysed uraemic patients; in dialysed patients its severity was related to the duration of dialysis; it was demonstrable even years after renal transplantation. On electron-microscopy, collagen fibres were seen, while beta 2-M amyloid was consistently absent. Logistic regression analysis showed that uraemia was a determinant of intermyocardiocytic fibrosis independent of hypertension, diabetes mellitus, anaemia, heart weight, and presence or absence of dialysis procedure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Aplastic / complications
  • Diabetes Mellitus, Type 2 / complications
  • Endomyocardial Fibrosis / etiology*
  • Endomyocardial Fibrosis / pathology
  • Female
  • Humans
  • Kidney Transplantation
  • Male
  • Myocardium / pathology
  • Regression Analysis
  • Renal Dialysis
  • Uremia / complications*
  • Uremia / therapy