Nephrol Dial Transplant (2000) 15: 239-243
© 2000 European Renal Association-European Dialysis and Transplant Association
Technical Reports
Measurement of glomerular volume in needle biopsy specimens
1 Department of Medicine, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne, 2 Clinical Data Operations, Merck, Sharp and Dohme Ltd, Hoddesdon, Hertfordshire and 3 Division of Medicine, South Tees Acute Hospitals NHS Trust, South Cleveland Hospital, Middlesbrough, Cleveland, UK
Correspondence and offprint requests to: Dr Jean M. MacLeod, c/o Secretary to Dr Bilous, Audrey Collins Teaching Unit, Education Centre, South Cleveland Hospital, Marton Road, Middlesbrough, Cleveland TS4 3BW, UK.
Abstract
Background. Various methods have been used to determine mean glomerular volume, some requiring measurement of over 30 glomerular profiles for a satisfactory estimate. Needle biopsies are useful diagnostically, but if small, provide insufficient tissue for the use of such methods.
Methods. We performed glomerular volume measurements on renal biopsies from 10 normotensive, non-uraemic patients with Type 1 diabetes. Sections were taken at 10 µm intervals through 10 glomeruli per biopsy and points landing on glomerular tuft counted under light microscopy. Volume was calculated from the measured cross-sectional area and known section thickness using the Cavalieri principle.
Results. Estimating the volume of 10 glomeruli per biopsy gave an overall mean glomerular volume of 4.21x106 µm3 and standard deviation between patient means 1.23x106 µm3. Using a sample size of five glomeruli per biopsy only increased the standard deviation between patient mean values by 3%. Using sections taken at 20 µm intervals made little difference to the mean glomerular volume and standard deviation estimates (MGV 4.20x106 µm3±1.24). Further increases in the sectioning interval resulted in an appreciable increase in the variance of the estimate.
Conclusions. The results suggest that a satisfactory estimate of mean glomerular volume can be obtained from a sample size of five glomeruli per biopsy using a sectioning interval of 20 µm. This represents a great saving in analysis time and effort, making widespread use of this method of glomerular volume measurement in renal disease more practicable, in both research and clinical settings.
Keywords: Cavalieri principle; glomerulopathy; glomerular volume; light microscopy; diabetes mellitus
Notes
* ESPRIT Study Group Members (European Study of the Progression of Renal Disease in Type 1 Diabetes). (UK) University of Newcastle upon Tyne: Dr J. M. MacLeod, Mrs K. E. White, Dr L. Baines, Dr S. Marshall and Dr R. W. Bilous; Guy's Hospital, London: Dr K. Earle, Dr D. Barnes, Dr I. Abbs, Miss A. Collins and Prof. G. C. Viberti; Northern General Hospital, Sheffield: Dr A. M. El Nahas; Merck, Sharp and Dohme Ltd, Hoddesdon, Herts: Dr P. Robinson, Ms H. Tate and Dr R. Tomiak. (Italy) Instituto di Richerche Farmacologiche Mario Negri, Bergamo: Dr P. Ruggenenti, Dr F. Gaspari and Dr G. Remuzzi; Ospedale Casa Sollieva della Sofferenza, San Giovanni Rotondo: Dr S. de Cosmo, Dr S. Bacci, Dr M. D'Errico; Ospedale San Michele, Cagliari: Dr G Piras. Steering Committee: Dr R. W. Bilous, Dr G. Remuzzi, Dr P. Robinson, Prof G. C. Viberti.
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