A quantitative analysis of the glomeruli in focal segmental glomerulosclerosis

Quantitative analysis of the glomerular area, mesangial matrix and mesangial cells was performed using renal biopsy specimens from 22 children with focal segmental glomerulosclerosis (FSGS) and 20 with minimal change nephrotic syndrome (MCNS). Non-sclerotic glomeruli were examined. All children in both groups showed nephrotic syndrome at the time of biopsy. Children with benign haematuria were examined as controls. Glomerular area increased with age in the FSGS, MCNS and control groups. The glomerular area was significantly greater in FSGS (1.5 +/- 0.4 x 10(4) microns 2) than in MCNS (1.2 +/- 0.2 x 10(4) microns 2) or in controls (1.2 +/- 0.3 x 10(4) microns 2) (P < 0.05). Mesangial matrix was increased with age in the three groups. The mesangial matrix was significantly increased in FSGS (28.3 +/- 4.0%; mesangial matrix area/glomerular area) compared with MCNS (24.9 +/- 4.1%) and controls (23.0 +/- 3.0%) (P < 0.01). These findings suggest that both glomerular hypertrophy and mesangial matrix increase in non-sclerotic glomeruli in FSGS may lead to glomerular sclerosis.