Summary
Aims: We aimed to develop an image analysis software that enabled measurement of glomerular basement membrane (GBM) thickness.
Methods: With this software, we evaluated the range of GBM widths found in a cohort of Asian patients diagnosed with a spectrum of renal diseases including minimal change/IgM nephropathy, focal and segmental glomerulosclerosis, IgA nephropathy, systemic lupus erythematosus nephritis, diabetic nephropathy, pauci-immune crescentic glomerulonephritis, thin basement membrane disease, and tubulointerstitial nephritis. Measurements were taken from a minimum of five glomerular capillary loops of each glomerulus. For each loop, at least 10 different points of the GBM were measured.
Results: The average GBM width measured for minimal change disease was 347.4 ± 9.0 nm, with the highest value being 403.9 nm and lowest being 214.7 nm. No association was found between GBM width and gender. We found a significant increase in GBM width in pathological states like lupus nephropathy (p < 0.0001), diabetic nephritis (p < 0.001) and tubulointerstitial nephritis (p < 0.01) as compared with minimal change disease. Only one case of thin membrane nephropathy (198.7 nm) was available for analysis and we found a significant thinning of the GBM.
Conclusions: These observations provide insights into the range of GBM thickness in several disease states and support the use of this novel software in the daily diagnostic laboratory setting.