Abstract: SA-PO119

The Change in the Glomerular Size According to the Type of Glomerular Disease and the Renal Function

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Imasawa, Toshiyuki, National Hospital Organization, Chiba-East Hospital, Chiba, Japan
  • Uehara, Masaki, National Hospital Organization, Chiba-East Hospital, Chiba, Japan
  • Yamakawa, Takafumi, National Hospital Organization, Chiba-East Hospital, Chiba, Japan
  • Kawaguchi, Takehiko, National Hospital Organization, Chiba-East Hospital, Chiba, Japan
Background

The glomerular size differs in each patient. Although it is assumed that the glomerular size should change according to the type of kidney disease and the hemodynamic state of the glomeruli, no clinical studies have investigated the impact of these factors on the glomerular size.

Methods

PAM-stained images of paraffin-embedded kidney sections were imported into a vertical slide system. The glomerular size was automatically calculated by manually outlining the glomerular tuft area on the display. We measured a total 18,673 glomeruli (with the exception of for globally sclerosed glomeruli) from 677 patients who underwent kidney biopsy in our hospital. All measurements were performed by a technical assistant in a blinded manner. In the present study, we especially focused on the glomerular sizes of patients with IgA nephropathy (IgAN) (n=212), diabetic nephropathy (DMN) (n=107), benign nephrosclerosis (BN) (n=78), and secondary focal segmental glomerulosclerosis (sFSGS) (n=53), and minimal change nephrotic syndrome (MCNS) (n=28). We also analyzed the glomerular sizes in patients with each stage of CKD.

Results

As shown in Figure, in CKD stages 1 and 2, the glomerular sizes of patients with diabetic nephropathy, benign nephrosclerosis, and secondary FSGS were significantly larger in comparison to patients with IgAN or MCNS (p < 0.05). In DMN and sFSGS, the sizes are similar in all CKD stages, while those in BN gradually decreased with the progression of the CKD stage. Conversely, the glomerular sizes of patients with IgAN gradually increased with the progression of the CKD stage.

Conclusion

The changes in glomerular size depend on the individual kidney disease. The pattern of the changes that occur with the progression of CKD should also differ according to the kidney disease.