title: The role of a low glomerular density and being overweight in the etiology of proteinuria in CKD patients without known glomerular diseases.
abstract: BACKGROUND
  Among the proteinuric patients with chronic kidney disease (CKD) who undergo a renal biopsy, we sometimes encounter those who cannot be classified as having a known primary or secondary glomerular disease. The pathogenesis and pathophysiology of these CKD patients have not been sufficiently elucidated.
  
  
  METHODS
  We recruited 34 proteinuric patients without known glomerular diseases. The glomerular volumes (GV) of the biopsy specimens from those patients were determined by a morphometric analysis. Glomerular hypertrophy (GH) was defined as having more than 3.6 × 10(6) μm(3). The patients were divided in two groups: those with GH (Group 1) and those without GH (Group 2). We compared the clinical and pathological parameters between Group 1 and Group 2, and among the three groups of patients: non-obese, overweight and obese group.
  
  
  RESULTS
  The patients with Group 1 had significantly higher values for the proportion of males, the body mass index (BMI), uric acid and significantly lower values for the glomerular density (GD). Of note, a multivariate regression analysis revealed that sex, the BMI and GD were significant factors correlated with the mean GV. The values for the mean GV were significantly higher in the overweight and obese groups as compared to the non-obese group, and the values for the GD were significantly lower in the obese group than in the non-obese group.
  
  
  CONCLUSIONS
  We identified a subgroup of patients who were characterized as having a high BMI and GV, and a low GD among the proteinuric CKD patients without known glomerular diseases.
authors: Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
authors: Hidekazu
authors: H
authors: Okamoto
authors: Tetsuya
authors: T
authors: Kawamura
authors: Hideo
authors: H
authors: Okonogi
authors: Nobuo
authors: N
authors: Tsuboi
authors: Yoichi
authors: Y
authors: Miyazaki
authors: Takashi
authors: T
authors: Yokoo
mesh_terms: D000328:Adult; D001706:Biopsy; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000473:pathology; D007564:Japan; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011507:Proteinuria / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D012737:Sex Factors