Morphometric analysis of the glomerular capillary area—a comparison of minimal change nephrotic syndrome, focal glomerular sclerosis, and pre‐eclampsia

Ishitobi, F; A, Sagiya; Ueda, Yoshihiko; Oka, Kazuo; Kanaya, Hiroaki; Iidaka, K

doi:10.1002/path.1711650409

Cited by 10 publications

(11 citation statements)

References 8 publications

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“…Using the morphometric analyses of Rumpelt et al [9]and Ishitobi et al [10], the microscopic images were recorded by a videocamera, then digitized and displayed on the computer monitor. For analysis, amyloid deposits on the arteriolar wall were encircled with the digital pen.…”

Section: Methodsmentioning

confidence: 99%

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Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Sasatomi

Kiyoshi²,

Uesugi³

et al. 2001

Nephron

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Progression of renal amyloidosis is associated with severe proteinuria or nephrotic syndrome, and various mechanisms have been postulated to explain these complications. We studied the acceleration of proteinuria and reduced renal function by cluster analysis using clinical parameters, renal histological findings, type of renal amyloidosis and follow-up data. We divided 97 cases into three groups of renal amyloidosis. Accelerated progression correlated with serum creatinine (s-Cr) levels at renal biopsy and histological grade of renal damage by amyloid deposition (p < 0.0001). The most influential prognostic factors (s-Cr level ≧2.0 mg/dl) were tubulointerstitial and vascular damage induced by amyloid deposition at biopsy (odds ratio 96.9 and 69.2, respectively). In addition, we found amyloidosis type amyloid associated (AA) correlated with more amyloid-mediated vascular and tubulointerstitial damage than amyloidosis type amyloid light chain (AL) (p < 0.001, p < 0.01, respectively). Proteinuria and nephrotic syndrome were more severe in cases of amyloidosis AL than in amyloidosis AA (p = 0.076). In conclusion, less tubulointerstitial and vascular damage was caused by amyloid deposition; this was slowly progressive. Amyloid AA was detected in tubulointerstitial tissue and vessels more frequently than amyloid AL. Heavy proteinuria and/or nephrosis were not indicators of rapid progression.

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Section: Methodsmentioning

confidence: 99%

“…We measured all cortical glomeruli in each visual field. The morphometric analysis of Rumpelt et al [9]and Ishitobi et al [10]were used for semiquantitative evaluation of the grade of pathological glomerular damage. The latter was determined based on staining of the sections with Congo red.…”

Section: Methodsmentioning

confidence: 99%

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Sasatomi

Kiyoshi²,

Uesugi³

et al. 2001

Nephron

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“…The glomerular capillary loop size was found to be significantly greater in progressive IgAN than in the non-CRF-IgAN group (1.37 times) or the controls (1.55 times). Ishitobi et al [13]found that pediatric patients with FSGS showed an average 1.4 times increase in the capillary loop area in comparison to minimal change nephrotic syndrome patients. The significant differences in the mean and standard deviation of the capillary loop area thus suggest that an unequal dilatation of these loops exists in IgAN and these glomeruli are also related strongly with progression.…”

Section: Discussionmentioning

confidence: 99%

“…They demonstrated that renal interstitial expansion caused by fibrosis destroys the tight structural and functional connection between the tubulus and peritubular capillaries. The obliteration of these capillaries leads to an increase in the resistance of the postglomerular capillary network and, therefore, to a rise in the intraglomerular pressure and, subsequently, to a dilatation of the glomerular capillaries in order to enlarge the glomerular tufts [13, 26]. We demonstrated a strong statistical correlation between A int and both glomerular tuft size (r 2 = 0.337, p < 0.001) and the glomerular capillary loop size (r 2 = 0.43, p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…According to Ishitobi et al [13], Rumpelt et al [14], and our recent analysis [15]the morphometric measurements were performed using a video overlay-based digitizing interactive tool (Hitachi Color System microscopic image analyzer, Japan). The microscopic image is recorded with the videocamera and displayed on the monitor screen using ‘Nikon Cosmosone’ software.…”

Section: Methodsmentioning

confidence: 99%

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Glomerular Hypertrophy as a Prognostic Marker in Childhood IgA Nephropathy

Tóth

Takebayashi²

1998

Nephron

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A clinicopathological and morphometric analysis of glomerular hypertrophy (GH) was conducted using biopsies obtained from 52 selected pediatric patients with IgA nephropathy (IgAN). Of the 52 patients, consisting of 12 with chronic renal failure (CRF) and 40 without CRF, various clinical and morphometric parameters were compared to 10 controls with benign hematuria. The mean glomerular tuft size, mesangial area, and interstitial area all significantly increased in patients with poor prognosis when compared to the non-CRF-IgAN cases and the control cases. The glomerular capillary loop size was also significantly greater in CRF-IgAN than in non-CRF-IgAn patients (1.37 times) and the controls (1.55 times). The 10-year renal survival rates of patients with ‘large’ loop size (>1.55-fold) were significantly lower (p < 0.001) than those of patients with a smaller capillary loop size. The size of the capillary loops was directly related to the relative interstitial area (A_int) (r² = 0.43, p < 0.001), to the degree of glomerulosclerosis (GS; r² = 0.348, p < 0.001) and the mesangial area (r² = 0.326, p < 0.001). Proteinuria tightly correlated with the capillary loop size (r² = 0.374, p < 0.001). It was not unexpected that a strong relationship was detected between the serum creatinine level and A_int (r² = 0.452, p < 0.001) and the percentage of GS (r² = 0.342, p < 0.001). In IgAN the percentage of GS correlated significantly with A_int (r² = 0.484, p < 0.001). GH, which was manifested by glomerular capillary loop dilatation, shows a close correlation with the interstitial expansion, degree of GS and mesangial enlargement. These data suggest that both extra- and intraglomerular hemodynamic changes followed by primary glomerular damage thus lead to capillary dilatation of the intact glomeruli as a morphological manifestation of GH and therefore such changes play a key role in the progression of IgAN.

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Glomerular dimensions in children under 16 years of age

Moore

Williams

Staples

1993

The Journal of Pathology

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Glomerular area, perimeter, and mean maximum glomerular diameter were assessed in post-mortem kidney tissue from 114 children who died suddenly in accidents and who were considered to have been previously healthy. One hundred glomeruli were measured from each case using a computer-based measurement system. Regression analysis was used to analyse glomerular size with respect to age, body weight, height, and body mass index. The estimated mean glomerular area for newborns was 7934 microns 2 (SE 314), increasing 8 per cent per year to 18,219 microns 2 at 15 years of age. The estimated mean maximum glomerular diameter increased from 112 microns (SE 1.9 microns) for newborns, approximately 3.6 microns per year to reach 167 microns at age 15. Glomerular size correlated better with age than with height, weight, or body mass index, and glomeruli in the inner cortex were significantly larger than those in the middle and outer cortex. Glomerular size was significantly greater in female children than in the male children over the age range examined.

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Morphometric analysis of the glomerular capillary area—a comparison of minimal change nephrotic syndrome, focal glomerular sclerosis, and pre‐eclampsia

Cited by 10 publications

References 8 publications

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Glomerular Hypertrophy as a Prognostic Marker in Childhood IgA Nephropathy

Glomerular dimensions in children under 16 years of age

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