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Glomerular basement membrane thickness in children: a stereologic assessment
Ian J Ramage1, Allan G Howatson, John H McColl
1Renal Unit, Department of Pathology, Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, Scotland, United Kingdom. i.ramage@clinmed.gla.uk
Kidney International
|August 8, 2002
Summary
Stereologic methods, specifically harmonic mean estimation (Th), are superior for measuring glomerular basement membrane (GBM) thickness. GBM thickness increases throughout childhood, with no significant gender influence observed.
Area of Science:
- Nephrology
- Pathology
- Biometry
Background:
- Glomerular basement membrane (GBM) thickness assessment is crucial in kidney disease.
- Stereologic methods, particularly harmonic mean of the orthogonal intercept estimation (Th), are increasingly favored over model-based arithmetic mean estimation (ATH).
- A direct comparison and establishment of a pediatric GBM thickness range were lacking.
Purpose of the Study:
- To establish the gold standard for GBM thickness estimation.
- To compare the stereologic technique (Th) with model-based methods (ATH).
- To determine the normal range of GBM thickness in children.
Main Methods:
- Compared Th and ATH for intra-observer and inter-glomerular variation in normal and attenuated GBM.
- Utilized 34,011 measurements from 212 pediatric kidney biopsies.
- Included patients with minimal change nephropathy, focal segmental glomerulosclerosis, and other conditions as normal surrogates.
Main Results:
- Th demonstrated significantly less variation than ATH.
- Pediatric GBM thickness increased from 194 nm at age 1 to 297 nm at age 11.
- The rate of GBM thickness increase slowed after age 11.
Conclusions:
- Stereologic methods (Th) are superior to model-based techniques for GBM thickness estimation.
- GBM thickness increases throughout childhood.
- No significant gender effect on GBM thickness was observed.
