It has been claimed that the loss of foot processes of the glomerular epithelial cells represents a non-specific response to protein leakage across a damaged glomerular basement membrane. The aim of the present study was to correlate permeability changes in the glomerulus for plasma proteins with ultrastructural alterations of the capillary wall in some human nephropathies and in particular to determine whether proteinuria per se may, in some way, damage epithelial cells. We selected for the study 16 patients with minimal changes nephropathy, 20 with membranous glomerulonephritis and 14 with toxemia of pregnancy. Renal tissue specimens were studied by light and electron microscopy. Endothelial cell damage was graded on a semiquantitative scale of 0 to 3 + according to Pirani et al. (1975). Particular attention was paid to glomerular epithelial cell lesions and an objective assessment of the presence and the degree of foot processes fusion was obtained according to Powell (1976). The study seems to indicate that: there is a close correlation between the degree of 'fusion' of glomerular epithelial cell foot processes and the amount of proteinuria in minimal change nephropathy and membranous glomerulonephritis but not in toxemia of pregnancy. The loss of protein through the glomerulus does not itself result in extensive spreading of the foot processes of epithelial cells.
|Number of pages||4|
|Publication status||Published - 1980|
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