Morphometry of podocytes – a single center study of pediatric patients: is there any correlation with proteinuria level?

Abstract

Introduction. The most common diagnosis after a kidney biopsy in pediatric population is minimal change disease. When the prognosis is not favorable in spite of the minimal change disease diagnosis, there is a clinical suspicion of focal segmental glomerulosclerosis. The objective of this study was to identify the ultramicroscopic changes in minimal change disease and focal segmental glomerulosclerosis focused on podocyte foot process effacement. Moreover, to find if there is a correlation between podocyte foot process effacement and proteinuria level. Material and methods. 100 patients were included in the study: 50 in the control group, 25 in the minimal change disease group and 25 in the focal segmental glomerulosclerosis group. For each patient 5 images were taken, focused on different capillary loops to identify podocyte foot process effacement. We measured the foot process effacement related to glomerular basal membrane. Furthermore, we investigated the possible correlation with proteinuria using statistical analysis. Results. The mean value of podocyte foot process effacement (%) in the control group was 8.42 ±4.59%, in the focal segmental glomerulosclerosis group was 55.44±16.17, while in the minimal change disease group it was 74.35±13.01. Compared with the proteinuria level, we established a correlation with foot process effacement (p value < 0.001) in the affected groups: minimal change disease and focal segmental glomerulosclerosis groups. Conclusions. In this study, we demonstrated that there is a correlation between proteinuria level and podocyte foot process effacement in children.

Keywords

• foot process effacement
• proteinuria
• pediatric population
• minimal change disease
• focal segmental glomerulosclerosis