Ultrastructural changes of podocyte foot processes during the remission phase of minimal change disease of human kidney
Ultrastructural changes of podocyte foot processes during the remission phase of minimal change disease of human kidney
复制标题
人肾微小病变缓解期足细胞足突超微结构的变化
DOI：
10.1111/nep.12256
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发表时间：
2014-07-01
期刊：
影响因子：
2.5
通讯作者：
Liu, Gang
中科院分区：
文献类型：
--
作者：
Liu, Xiao-Jing;Zhang, Yi-Miao;Liu, Gang
目的观察微小病变病（MCD）患者缓解期足细胞足突的超微结构变化及其与蛋白尿量的关系。方法对33例成人MCD患者的肾小球毛细血管进行电镜观察，其中肾病综合征12例，部分缓解15例，完全缓解6例。根据足突的高宽比将足突分为0.5 ~ 1、1-2和2级。测量肾小球基底膜（GBM）足突宽度（FPW）及每10 m不同级别足突数目。选择12例肾癌切除的正常肾组织作为对照。结果FPW在肾病组（1566.4 ± 429.4nm）、部分缓解组（1007.8 ± 234.9nm）、完全缓解组（949.8 ± 168.2nm）和正常对照组（471.9 ± 51.8nm）之间差异有统计学意义（P=0.001）。高宽比为2时，正常组每10 m GBM的足突数明显多于完全缓解组（0.84 ± 0.24 vs. 3.84 ± 1.80，P=0.016）。三组患者的平均FPW与尿蛋白水平相关（r=0.506，P=0.003）。结论蛋白尿与足突消失可能无因果关系。完全缓解期FPW及足突形态未恢复正常，蛋白尿消失。
Aim The current study was designed to observe the ultrastructural changes of podocyte foot processes during the remission phase and its relationship with the amount of the proteinuria in patients with minimal change disease (MCD). Methods Electron micrographs of glomerular capillaries were taken from 33 adult cases with MCD, including 12 cases with nephrotic syndrome, 15 cases in partial remission and six cases in complete remission. The foot processes were classified into three grades by the ratio of the height to basal width: 0.5-1, 1-2 and 2. The foot process width (FPW) and the number of foot processes in different grades per 10m of glomerular basement membrane (GBM) were measured. Normal renal tissues from 12 nephrectomies for renal carcinoma were selected as controls. Results There were statistical differences (P=0.001) in the mean FPW among the nephrotic group (1566.4 +/- 429.4nm), partial remission group (1007.8 +/- 234.9nm), complete remission group (949.8 +/- 168.2nm) and normal controls (471.9 +/- 51.8nm). For the height-to-width ratio 2, the number of foot process per 10m GBM was significantly greater in the normal group than that in the complete remission group (0.84 +/- 0.24 vs. 3.84 +/- 1.80, P=0.016). Taking all three groups of patients together, the mean FPW showed correlation with the level of proteinuria (r=0.506, P=0.003). Conclusion There may be no causal relationship between proteinuria and foot process effacement. In complete remission phase, both FPW and shape of foot process had not returned to normal while proteinuria disappeared.