Abstract: SA-PO0954
Classification of Glomerulomegaly for the Prognostication of Kidney Disease
Session Information
- Pathology: Updates and Insights
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Ritchie, Leanna V., Mayo Clinic in Florida, Jacksonville, Florida, United States
- Aslam, Nabeel, Mayo Clinic in Florida, Jacksonville, Florida, United States
- Ma, Yaohua, Mayo Clinic in Florida, Jacksonville, Florida, United States
- Albadri, Sam, Mayo Clinic in Florida, Jacksonville, Florida, United States
Background
Glomerulomegaly refers to the pathological finding of enlarged individual glomeruli on kidney histology. Various definitions have been proposed, including a diameter exceeding 200 microns or 1.5 times that of a "normal glomerulus." However, there is currently no standardized criterion for classifying glomerulomegaly. This study aims to establish the normal range for glomerular size and determine the percentage of glomeruli that exceed this size as a normal variant.
Methods
In this study we compared the size of the glomeruli between the living kidney donor recipients’ protocol biopsy at 4 month post-transplant (control group – normal kidneys N=145) and native kidney biopsy specimens that were described to have “glomerulomegaly” by the reporting pathologists (Glomerulomegaly cases group n=85). All glomeruli in the biopsy specimen were measured from hilum to antihilum using measurement tool on digitally scanned kidney pathology specimens.
Results
Review of digital images of kidney biopsies identified a “normal” glomerular size and distribution. Using a Receiver Operating Characteristic plot, we identified glomerulomegaly to be best defined as ≥10% of glomeruli with hilum-antihilum diameter >230 μm with a sensitivity of 70.6% and specificity of 79.3%. In our control group 29% had glomeruli diameter > 200 μm. See attached figure of ROC plot demonstrating glomerular diameter> 230 μm cut off having greatest area under the curve for maximal sensitivity and specificity.
Conclusion
We propose the first criterion for glomerulomegaly hilum-antihilum diameter >230 μm in >10% of the glomeruli to standardize its identification on histology. Next, we will evaluate clinical outcomes within each cohort to devise a glomerulomegaly risk stratification system.