Ak. Das et al., GLOMERULAR-BASEMENT-MEMBRANE THICKNESS - A COMPARISON OF 2 METHODS OFMEASUREMENT IN PATIENTS WITH UNEXPLAINED HEMATURIA, Nephrology, dialysis, transplantation, 11(7), 1996, pp. 1256-1260
Background. Thin glomerular basement membranes may be an important cau
se of microscopic haematuria. Unfortunately measurements are often not
made because of the complicated methods currently employed. Methods.
A simplified method of measurement of glomerular basement membrane thi
ckness, involving only 16 selected measurements on a single glomerulus
, was compared with the accepted, but time-consuming, orthogonal inter
cept technique. Thirty-one needle biopsies from patients with renal ha
ematuria unexplained by conventional histology and immunofluorescence
were studied. Measurements were made on the same ultrathin sections. R
esults. The new method was found to give much lower values (mean (SD)
202 +/- 51 versus 282 +/- 52 nm) with limits of agreement of - 131 to
- 30 nm compared with the orthogonal intercept method. The coefficient
of repeatability was 39 nm for the orthogonal intercept method and 56
nm for the new method. However, using two glomeruli the new method ha
d limits of agreement of - 120 to - 41 nm with a coefficient of repeat
ability of 38 nm. Conclusions. Provided two glomeruli are measured the
new technique is sufficiently accurate for the diagnosis of thin memb
rane nephropathy, in appropriate cases, and is much simpler and cheape
r than the orthogonal intercept method.