Abstract: FR-PO579

The Quantitative Evaluation of Glomerular Collapse Predicts the Long-Term Renal Outcome in Patients with Benign Nephrosclerosis

Session Information

Category: Hypertension

  • 1104 Hypertension: Clinical and Translational - Salt and Hypertension

Authors

  • Haruhara, Kotaro, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Tsuboi, Nobuo, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Amano, Hoichi, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Koike, Kentaro, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Kanzaki, Go, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Okabayashi, Yusuke, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Sasaki, Takaya, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Ogura, Makoto, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
  • Yokoo, Takashi, Division of nephrology and hypertension, The Jikei university school of medicine, Tokyo, Japan
Background

Although the concomitant appearance of glomerular collapse and enlargement is a typical renal histological feature in benign nephrosclerosis (BNS), the definition of glomerular collapse has not been established. The aim of this study was to quantify the severity of glomerular collapse and to examine the predictive significance of this parameter regarding the renal outcome in patients with biopsy-proven BNS.

Methods

The clinical data and renal biopsy specimens from BNS patients with an eGFR of >30 mL/min/1.73m2 were retrospectively reviewed. Based on the measurements of all cross-sectional areas of Bowman's capsules and glomerular capillaries in the specimens, the mean volume of the Bowman’s capsules (BV) and the mean volume of the glomerular capillaries (GV) were separately calculated for each subject using Weibel’s equation. The G/B ratio was defined as the ratio of GV to BV.

Results

This study included a total of 67 BNS patients, with a median G/B ratio of 0.615. The clinicopathological characteristics at the biopsy of the patients with a G/B ratio of >0.615 and those with a value of <0.615 were comparable, whereas the GV values of the patients with a G/B ratio of >0.615 were larger in comparison to the patients with a G/B ratio of <0.615. The survival analyses showed that a G/B ratio of <0.615 was associated with a worse renal outcome (Figure). In the Cox hazard analysis to determine the factors associated with the doubling of serum creatinine levels, a G/B ratio of <0.615 was found to be a significant predictor after adjustment by age, sex, and GV <median.

Conclusion

These results suggest that the G/B ratio of diagnostic biopsy specimens is a useful predictor of the long-term renal outcome in patients with BNS, the pathogenesis of which may involve glomerular collapse.