October 11, 2017
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 SP, Troxell ML, Hecox D, Sperling KR, Seshan SV. Smoking-related glomerulopathy: expanding the morphologic spectrum. Am J Nephrol. 2015;41(1):66-72. PMID: 25659349