Comparative evaluation of glomerular morphometric techniques reveals differential technical artifacts between focal

Anand C Reghuvaran1, Qisheng Lin2, John M Basgen3

  • 1Division of Nephrology, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.

PubMed

Insights

Glomerular volume estimation using a novel 3-profile method shows improved accuracy and reduced bias compared to existing techniques. This method offers a more precise way to assess kidney disease, even with fewer glomeruli samples.

Area of Science:

  • Nephrology
  • Quantitative Pathology
  • Biomedical Engineering

Background:

  • Morphometric estimation of glomerular volume (MGV, IGV) is crucial for understanding kidney disease but is often limited by time and expertise.
  • Existing methods for glomerular morphometry, such as the Cavalieri (Cav) method, 2-profile, and Weibel-Gomez (WG) methods, have limitations in accuracy, bias, and precision.
  • Focal segmental glomerulosclerosis (FSGS) is a significant kidney disease where glomerular morphometry can provide valuable insights.

Purpose of the Study:

  • To evaluate and compare the accuracy, bias, and precision of different methods for estimating mean glomerular volume (MGV) and individual glomerular volume (IGV).
  • To assess the impact of varying glomerular sampling numbers on the precision of MGV estimates.
  • To introduce and validate a novel 3-profile method for glomerular morphometry and compare it with existing techniques.

Main Methods:

  • Morphometric analysis of MGV and IGV was performed on plastic- and paraffin-embedded kidney tissue from control and FSGS mice using the Cavalieri (Cav) method, 2-profile, Weibel-Gomez (WG), and a novel 3-profile method.
  • Accuracy, bias, and precision were compared across methods and with different numbers of glomeruli sampled (5, 10, 20).
  • Tissue shrinkage artifacts between plastic- and paraffin-embedded samples were quantified.

Main Results:

  • An acceptable precision for MGV estimation was achieved with 10-glomerular sampling using the Cav method, while 5-glomerular sampling was less precise.
  • The 2- and 3-profile methods showed greater concordance with Cav-based MGV in plastic-embedded tissue compared to WG.
  • A consistent underestimation bias was observed with 2- and 3-profile methods for IGV compared to the Cav method, with greater variability in FSGS glomeruli.
  • The novel 3-profile method demonstrated incremental benefits over the 2-profile method, showing improved correlation, Lin's concordance, and reduced bias.
  • A significant shrinkage artifact (52%) was quantified in paraffin-embedded versus plastic-embedded control tissues, with reduced but variable shrinkage in FSGS glomeruli.

Conclusions:

  • The novel 3-profile method offers improved concordance and reduced bias for glomerular volume estimation compared to the 2-profile method.
  • Glomerular morphometry, particularly with optimized sampling strategies, provides valuable biological data beyond qualitative histology.
  • Understanding tissue processing artifacts, like shrinkage, is critical for accurate morphometric analysis in kidney disease studies.