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Currently filtering by tag: Obesity


This biopsy was performed on a 26 year old muscular male with history of persistent subnephrotic proteinuria (UPCR = 2.3 g/g) and preserved renal function. Serum albumin is maintained at 4.2 gm/dl with the remaining serologic workup negative. BMI is 38.2 kg/m2. Of note, the patient has a history of premature birth and has a twin brother with similar clinical presentation. The biopsy shows marked glomerular hypertrophy (Fig 1 and 2) with no evidence of segmental glomerulosclerosis, tubulointerstitial scarring, immune complex deposition or significant foot process effacement. Glomerular hypertrophy (glomerulomegaly) is a form of adaptive structural-functional response which occurs as...

Pushing Glass (June 13, 2017)

A 69-year-old African American woman had a kidney biopsy due to CKD III-IV. Her medical history is significant for morbid obesity, diabetes mellitus (>5 years), hypertension (>5 years), coronary artery disease status post stent, hypothyroidism, gout and chronic kidney disease. Her renal ultrasound shows an unremarkable simple left renal cyst and increased echogenicity in both kidneys. Investigations show serum creatinine which has increased to 4.9 mg/dl. Proteinuria is up to 3.7 gm/day. Serological studies are negative. The images are characteristic findings of which of the following: 1. Sarcoidosis 2. Acute Tubular Injury 3. Uric Acid Nephropathy 4. Interstitial Nephritis 5....

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...