title: Glomerular density-associated changes in clinicopathological features of minimal change nephrotic syndrome in adults.
abstract: BACKGROUND
  Differences in nephron number and/or glomerular size between individuals, in relation to intrauterine growth retardation or low birth weight, have been suggested to affect the clinical course of minimal change nephrotic syndrome (MCNS) in children. However, no previous study has investigated the potential influences of these histological variables on the clinical course of adult patients with MCNS.
  
  
  METHODS
  The glomerular density (GD; the number of non-sclerotic glomeruli per renal cortical area) and the glomerular volume (GV) were evaluated using renal biopsy specimens from adult patients with a histological diagnosis of MCNS (n = 50). Relationships between these variables and clinicopathological features, including the initial response to corticosteroid therapy, were analyzed.
  
  
  RESULTS
  Both the GD (1.5-6.5/mm(2)) and the GV (1.2-4.4 × 10(6) μm(3)) showed about 4-fold variations, and a close inverse correlation was observed between these two variables. Notably, the MCNS patients with a low GD showed a trend towards having similar clinicopathological characteristics as patients with a histological diagnosis of focal segmental glomerular sclerosis, as compared to the MCNS patients with a high GD. In addition, during the initial treatment with corticosteroids, the number of patients achieving complete remission was significantly lower in the MCNS patients with a low GD than that in the MCNS patients with a high GD.
  
  
  CONCLUSIONS
  These results suggest that the GD in renal biopsies may be an important determinant of the glomerular size variability, and can therefore influence the clinical phenotype, such as the response to corticosteroid therapy, in adult patients with MCNS.
authors: Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. kkoike@jikei.ac.jp
authors: Kentaro
authors: K
authors: Koike
authors: Nobuo
authors: N
authors: Tsuboi
authors: Yasunori
authors: Y
authors: Utsunomiya
authors: Tetsuya
authors: T
authors: Kawamura
authors: Tatsuo
authors: T
authors: Hosoya
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D005919:Glomerular Filtration Rate; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology*; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009399:Nephrons / Q000473:pathology; D009402:Nephrosis, Lipoid / Q000473:pathology*; D010641:Phenotype; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones