Urinary podocytes in childhood IgA nephropathy

We have previously demonstrated the presence of detached podocytes in the u rine in various glomerular diseases. In this study, we investigated the pat hological significance of detachment of urinary podocytes (u-podocytes) in childhood IgA nephropathy. We investigated 28 children with IgA nephropathy . U-podocytes were detected in the urinary sediment by immunofluorescence. Renal pathological changes and urinalysis, including the u-podocyte test, w ere analysed. The expression of glomerular basement membrane (GBM) componen ts, integrins and cytoskeleton components on urinary podocytes was investig ated using dual immunofluorescence in 12 patients. The u-podocyte score par alleled the acute glomerular changes in renal biopsy samples. The infiltrat ion of glomerular macrophages and polymorphonuclear leucocytes, and the num ber of urinary leucocytes, correlated highly with the u-podocyte score. Som e of the u-podocytes expressed integrins and also components of the GBM. De tachment of podocytes reflects the presence of acute glomerular lesions. In filtration of glomerular leucocytes is considered to be the cause of the de tachment, partly because of the destruction of the GBM.