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Currently filtering by tag: Hyperfiltration


This glomerulus is large! Glomerular enlargement, or glomerulomegaly, may be diagnosed when a glomerulus sectioned through the hilum fills greater than 50% of a 40x microscopic field. It is thought to be a morphologic marker of glomerular hyperfiltration. While not specific, glomerulomegaly is often seen in patients with obesity-related glomerulopathy, in which case there is often the additional finding of focal segmental glomerulosclerosis. More recently, Salvatore and colleagues found glomerulomegaly in association with either diffuse mesangial or nodular glomerulosclerosis in all patients with chronic renal insufficiency and proteinuria who had a prolonged history of smoking and hypertension (see reference). Salvatore...

Obesity-Related Glomerulopathy

This biopsy is from a 61 year-old, morbidly obese patient, who presents with 6 month history of persistent proteinuria (UPCR: 3.7 gm/gm).  The displayed glomerulus is enlarged and shows an area of segmental sclerosis involving the perihilar region of the glomerulus. Additionally, electron microscopy showed only mild epithelial foot process effacement, and immunofluorescence was completely negative. All these morphologic features are supportive of a secondary (adaptive) form of focal segmental glomerulosclerosis (FSGS).  FSGS is a pattern of glomerular injury which may be primary or secondary.  One form of secondary FSGS is believed to be the result of glomerular hyperfiltration which...