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Quantitative relationship between glomerular foot process width and proteinuria in glomerulonephritis

T Seefeldt, S O Bohman, H Jørgen

Laboratory Investigation; a Journal of Technical Methods and Pathology

|June 1, 1981

Summary

Foot process width in kidney biopsies is linked to proteinuria, but the connection is complex. Not all proteinuria cases show abnormal foot process width, suggesting other mechanisms are involved.

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Area of Science:

Nephrology
Pathology
Electron Microscopy

Background:

Foot process fusion (retraction) is a known factor in glomerular diseases and proteinuria.
Quantitative studies on foot process width and proteinuria are limited.

Purpose of the Study:

To quantitatively assess true foot process width in glomerulonephritis patients.
To correlate foot process width with diurnal urinary protein excretion.
To evaluate the relationship between quantitative and semiquantitative methods for foot process fusion assessment.

Main Methods:

Quantitative morphometry to estimate true foot process width from electron micrographs.
Analysis of patient data including glomerulonephritis diagnosis and diurnal urinary protein excretion.
Methodologic comparison of quantitative and semiquantitative foot process fusion estimation.

Main Results:

A weak correlation was found between true foot process width and diurnal urinary protein excretion.
Abnormal foot process width was associated with proteinuria, but many patients with significant proteinuria had normal foot process width.
Foot process fusion is not invariably caused by proteinuria, nor is proteinuria solely caused by foot process fusion.

Conclusions:

Foot process fusion is not the sole cause of proteinuria in glomerular diseases.
Proteinuria does not necessarily lead to foot process fusion.
The semiquantitative method for assessing foot process width is precise enough for most clinical kidney biopsy evaluations.