Pathological and clinical characteristics of late-onset oligomeganephronia based on a histomorphometric study

© 2023. The Author(s)..

BACKGROUND: Late-onset oligomeganephronia (OMN) is a rare chronic kidney disease and has no quantitative criteria for diagnosis yet. The current study aimed to explore its clinicopathological features by histomorphometric analysis.

METHODS: We retrospectively re-reviewed all patients with enlarged and sparse glomeruli by light microscopy at Peking University First Hospital from 2012 to 2021, excluding those with any factor known to contribute to similar changes. Age- and sex-matched patients with thin basement membrane nephropathy were selected as control to establish the cut-off values for glomerulomegaly and rarity. Late-onset OMN cases were then confirmed and the clinicopathological characteristics were summarized.

RESULTS: Mean diameter and density of cortical glomeruli in control was 156.53 ± 27.50 μm and 4.07 ± 0.63 /mm2, giving a lower limit of 211.53 μm for glomerulomegaly and an upper of 2.81 /mm2 for rarity. Seven adults of three females and four males were finally diagnosed as late-onset OMN with a mean age of 26.57 years. They showed mild to moderate proteinuria and/or renal dysfunction at biopsy with the mean proteinuria, serum creatinine (Scr) level, and estimated glomerular filtration rate of 0.50 g/d (0.10-0.95 g/d), 140.9 µmol/L (95.1-227.1 µmol/L), and 58.7 mL/min/1.73m2 (21.3-98.0 mL/min/1.73m2), respectively. Four patients (57.1%) had normal Scr at diagnosis. Six patients with available data showed renal tubular injury with increased urinary microalbumin in all, elevated N-acetyl-β-glucosaminidase in two, and elevated α1 microglobulin in five. Kidney size was normal or slightly reduced. The mean density and glomerular diameter of the seven cases was 0.86 mm2 (0.55-1.41 /mm2) and 229.73 μm (211.88-260.66 μm). Segmental glomerular sclerosis was observed in six (85.7%) with four (66.7%) of perihilar type. Proximal tubule dilation was observed in all, focal to diffuse, lining with enlarged epithelial cells. The mean foot process width was 634.02 nm, wider than 472.54 nm of the control (P = 0.0002).

CONCLUSION: Late-onset OMN should be considered a special entity with relatively slow clinical progress characterized by hypertrophy of the sparsely distributed nephron.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:24

Enthalten in:

BMC nephrology - 24(2023), 1 vom: 15. März, Seite 54

Sprache:

Englisch

Beteiligte Personen:

Ren, Ya-Li [VerfasserIn]
Li, Yang [VerfasserIn]
Gao, Jie [VerfasserIn]
Zhou, Xu-Jie [VerfasserIn]
Yang, Li [VerfasserIn]
Wang, Su-Xia [VerfasserIn]

Links:

Volltext

Themen:

Adult
Chronic kidney disease
Glomerulomegaly
Histomorphometry
Journal Article
Oligomeganephronia
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 20.03.2023

Date Revised 25.03.2023

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12882-023-03096-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM354282891