HUMAN GLOMERULAR STRUCTURE UNDER NORMAL CONDITIONS AND IN ISOLATED GLOMERULAR-DISEASE

Investigation of the human glomerulus in health and disease shows that the human glomerulus comprises seven lobule-like structures with nume rous anastomoses. The total length of the capillaries in a single glom erulus is 0.95 cm; making a total of 19 km for all 2-million glomeruli . The total surface area of all glomerular capillaries is 6,000 cm(2). The total filtration surface area is 516.1 cm(2). Severe isolated dis ease of the glomerulus, as seen in acute endocapillary glomerulonephri tis, membranoproliferative glomerulonephritis types I and II membranop roliferative glomerulonephritis plus chronic membranous glomerulonephr itis, diabetic glomerulosclerosis, and glomerular amyloidosis, does no t lead to elevation of serum creatinine concentration, even if the fil tration area is reduced to about 20% las in diabetes) of the normal va lue. It is concluded that isolated glomerular disease does not lead to elevation of the serum creatinine concentration. Glomerulopathies in which there is acute or chronic elevation of the serum creatinine conc entration are accompanied by acute renal failure or involvement of the renal cortical interstitium, respectively.