THE GLOMERULAR DEPOSITION OF PAS POSITIVE MATERIAL CORRELATES WITH RENAL-FUNCTION IN HUMAN KIDNEY-DISEASES

General agreement exists on the correlation of renal insufficiency wit h the severity of tubulointerstitial abnormalities in the biopsy. This could not be shown for the severity of glomerular pathology by semiqu antitative methods. The relation between renal function and glomerular pathology was therefore evaluated in patients with various kidney dis eases using quantitative measurements. Fifty-five patients and ten con trols were studied. Histomorphometric measurements of renal biopsies w ere obtained for both frozen and paraffin sections and were correlated with serum creatinine values. The frozen sections were stained with a n indirect immunoperoxidase technique using antibodies against collage n types I, IV, V, VI, laminin, fibronectin, decorin and heparansulphat e proteoglycan core protein. The contribution of each component to the composition of the mesangial extracellular matrix was scored with a s emiquantitative technique. All glomerular histomorphometric indices co rrelated with the severity of renal insufficiency expressed as serum c reatinine at the time of biopsy. However, quantitative estimates of th e glomerular deposition of periodic acid-Schiff positive extracellular matrix seemed to be the most important structural correlate of renal function (r = 0.524, p = 0.0001). Semiquantitative estimates of inters titial extracellular matrix accumulation were less correlated with ren al function (r = 0.370, p = 0.01). The composition of the mesangial ex tracellular matrix did not differ in patients and controls, with the e xception of the extent of laminin staining, which was significantly hi gher in patients. The extent of fibronectin staining in patients corre lated with the severity of glomerular structural abnormalities. This s tudy demonstrates that the severity of renal insufficiency in a variet y of renal diseases correlates with the severity of glomerular patholo gy when quantitative scoring is applied.