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Glomerular endothelial cell injury and focal segmental glomerulosclerosis lesion in idiopathic membranous nephropathy

Megumi Morita1, Akiko Mii1, Akira Shimizu2

  • 1Department of Nephrology, Nippon Medical School, Tokyo, Japan.

Plos One
|April 16, 2015
PubMed
Abstract

Insights

Focal segmental glomerulosclerosis (FSGS) lesions in membranous nephropathy (MN) are linked to reduced kidney function. Prominent glomerular capillary injury contributes to FSGS development in MN patients.

Area of Science:

  • Nephrology
  • Pathology
  • Glomerular Diseases

Background:

  • Focal segmental glomerulosclerosis (FSGS) is a known negative predictor in idiopathic membranous nephropathy (MN).
  • The precise mechanisms driving FSGS lesion development in MN remain unclear.

Purpose of the Study:

  • To compare clinicopathological features between MN patients with and without FSGS lesions.
  • To investigate the role of glomerular capillary injury in FSGS formation within MN.

Main Methods:

  • Retrospective analysis of 250 MN cases, identifying 26 with FSGS lesions.
  • Clinicopathological comparison between MN-FSGS(+) and MN-FSGS(-) groups, matched for age, gender, and MN stage.

Main Results:

  • MN-FSGS(+) cases exhibited significantly lower estimated glomerular filtration rate (eGFR).
  • Glomerular capillary injury, including endothelial cell loss and extracellular matrix accumulation, was more prominent in MN-FSGS(+) cases.
  • FSGS lesions (NOS and perihilar types) were identified in 8.2% of glomeruli in MN-FSGS(+) cases.

Conclusions:

  • Glomerular capillary injury is a common finding in all MN cases.
  • More severe glomerular capillary injury is associated with decreased eGFR and the development of FSGS lesions in MN.

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