Podocyte injury predicts prognosis in patients with IgA nephropathy using a small amount of renal biopsy tissue
Podocyte injury predicts prognosis in patients with IgA nephropathy using a small amount of renal biopsy tissue
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DOI：
10.1159/000054214
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发表时间：
2001-01-01
影响因子：
2.8
通讯作者：
Tomino, Y
中科院分区：
文献类型：
--
作者：
Hishiki, T;Shirato, I;Tomino, Y
为了预测伊加肾病患者的进展，我们通过形态计量学分析，分析了34例IgA肾病患者的肾小球病变（硬化、粘连和/或新月体除外）。以肾活检时的尿蛋白排泄量（UP）、肌酐清除率（Ccr）、血清肌酐（sCr）和平均血压（MBP）作为临床指标。1/sCr的斜率也用作预后参数。通过超声引导活检获得肾脏标本。在PAS染色的光学显微镜肾切片中，选择开放肾小球的三个中间切片并拍照，进行体视学估计如下：肾小球体积（V-G）、肾小球表面积（S-G）、每个肾小球的足细胞和非足细胞数量（N-G（pod）和NG（Non-pod））的绝对值，一个足细胞S-G/N-G（pod）覆盖的肾小球表面积和一个非足细胞占据的肾小球体积（V-G/NG（Non-pod））UP水平与足细胞损伤参数（N-G（pod）和S-G/N-G（pod））或NG（Non-pod）N-G（pod）的变化有显著相关性而S-G/N-G（POD）和NG（Non-POD）与UP呈正相关。S-G/N-G（pod）或NG（Non-pod）与MBP相关。N-G（pod）、S-G/ N-G（pod）、NG（Non-pod）、UP或MBP与1/sCr斜率显著相关。N-G（pod）、S-G/N-G（pod）和MBP具有高度特异性。还观察到NG（非豆荚）和UP的高灵敏度。足细胞损伤可能为伊加肾病患者提供额外的预后信息。版权所有（C）2001 S. Karger AG.巴塞尔。
To predict the progression in patients with IgA nephropathy, we analyzed glomerular lesions except for sclerosis, adhesion and/or crescents in 34 patients with this disease by morphometric analysis. Levels of urinary protein excretion (UP), creatinine clearance (Ccr), serum creatinine (sCr) and mean blood pressure (MBP) at the time of renal biopsy were used as the clinical parameters. The slope of 1/sCr was also used as a prognostic parameter. Renal specimens were obtained by echo-guided biopsy. In PAS-stained light microscopic renal sections, three midsections of open glomeruli were selected and photographed, Stereologic estimation was performed as follows: absolute values of glomerular volume (V-G), glomerular surface area (S-G), podocyte and nonpodocyte cell number per glomerulus (N-G(pod) and NG(Non-pod)), glomerular surface area covered by one podocyte S-G/N-G(pod)) and glomerular volume occupied by one nonpodocyte cell (V-G/NG(Non-pod)) There was a significant correlation between the levels of UP and the change of podocyte injury parameters (N-G(pod) and S-G/N-G(pod)) or NG(Non-pod) N-G(pod) was negatively but S-G/N-G(pod) and NG(Non-pod) were positively correlated with UP. S-G/N-G(pod) or NG(Non-pod) was correlated with MBP. N-G(pod), S-G/ N-G(pod), NG(Non-pod), UP or MBP was significantly correlated with the slope of 1/sCr, High specificity was observed for N-G(pod), S-G/N-G(pod) and MBP. High sensitivity was also observed for NG(Non-pod) and UP. It appears that podocyte injury might provide additional prognostic information in patients with IgA nephropathy. Copyright (C) 2001 S. Karger AG. Basel.