Towards a definition of glomerulomegaly: clinical-pathological and methodological considerations

Hughson, Michael D., Hoy, Wendy E., Douglas-Denton, Rebecca N., Zimanyi, Monika A. and Bertram, John F. (2011) Towards a definition of glomerulomegaly: clinical-pathological and methodological considerations. Nephrology Dialysis Transplantation, 26 7: 2202-2208. doi:10.1093/ndt/gfq688


Author Hughson, Michael D.
Hoy, Wendy E.
Douglas-Denton, Rebecca N.
Zimanyi, Monika A.
Bertram, John F.
Title Towards a definition of glomerulomegaly: clinical-pathological and methodological considerations
Journal name Nephrology Dialysis Transplantation   Check publisher's open access policy
ISSN 0931-0509
1460-2385
Publication date 2011-07
Sub-type Article (original research)
DOI 10.1093/ndt/gfq688
Volume 26
Issue 7
Start page 2202
End page 2208
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2012
Language eng
Formatted abstract
Background.
Glomerulomegaly, the abnormal enlargement of glomeruli, has been related to an increased risk of glomerulosclerosis, but the degree of enlargement that constitutes glomerulomegaly has not been defined.

Methods.
The principal stereological methods for estimating glomerular volume are [1] the disector/Cavalieri method that is considered the ‘gold standard’ for measuring individual glomerular volume (IVglom) and [2] the disector/fractionator technique that estimates average glomerular volume (Vglom) together with total glomerular number (Nglom) for the entire kidney. The two methods produce different estimates with Vglom consistently exceeding IVglom. This study compares glomerular volumes obtained by the two methods in autopsy kidneys of 39 African American and 34 US white adult males, and correlates the values with Nglom, body mass index (BMI), hypertension, glomerulosclerosis and race, factors known or thought to influence glomerular volume.

Results.
For the smallest glomeruli, Vglom was 25% larger than IVglom with the difference increasing to over 50% for kidneys with the largest glomeruli. Both Vglom and IVglom showed significant inverse correlations with Nglom and significant direct correlations with BMI and hypertension. African Americans had larger IVglom and Vglom than whites, but only IVglom was significant. The 90th percentile for IVglom was 6.81 μm3 × 106 and 13.10 μm3 × 106 for Vglom, but larger glomerular size did not separate hypertensive from non-hypertensive subjects nor did it show any significant relationship to glomerulosclerosis. While Vglom overestimated glomerular size compared with IVglom, both measurements demonstrated similar relationships to factors influencing glomerular volume.

Conclusions.

With neither method could glomerulomegaly, the abnormal enlargement of glomerular size predisposing to glomerulosclerosis, be determined.
Keyword Body mass index
Glomerular number
Glomerulomegaly
Hypertension
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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