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Structure of Glomerular Capillaries in Proteinuria

Structure of Glomerular Capillaries in Proteinuria Abstract The appearance of large quantities of protein in the urine has long been associated with changes in the renal architecture, although the precise lesion or lesions responsible for this abnormality are not clearly understood. Normally some protein is filtered at the glomerulus and reabsorbed by the tubules. Several investigators have therefore suggested that urinary protein loss is due to failure of the tubular reabsorptive mechanism.1 The majority, however, has attributed the development of proteinuria to increased permeability of glomerular capillaries to plasma proteins.2 Before the advent of electron microscopy, those who held this view could correlate proteinuria only with a general disturbance of the glomerulus, as seen in acute or chronic glomerulonephritis or in diabetic glomerulosclerosis. Changes in the capillary walls, often observed with a light microscope, proved difficult to study and to evaluate.3,4 The application of electron microscopy to biopsy specimens permitted much better visualization of References 1. Freeman, T., and Joekes, A. M.: Nephrotic Proteinuria: A Tubular Lesion? Acta Med. Scand. 157:43-50, 1957.Crossref 2. Derow, H. A.: The Nephrotic Syndrome , New Engl. J. Med. 258:77-82; 124-129, 1958.Crossref 3. Bell, E. T.: Renal Diseases , Ed. 2, Philadelphia, Lea & Febiger, 1950. 4. Churg, J., and Grishman, E.: Subacute Glomerulonephritis , Amer. J. Path. 35:25-45, 1959. 5. Farquhar, M. G.; Vernier, R. L., and Good, R. A.: Studies on Familial Nephrosis , Amer. J. Path. 33:791-817, 1957. 6. Spiro, D.: The Structural Basis of Proteinuria in Man , Amer. J. Path. 35:47-73, 1959. 7. Kark, R. M., and Muehrcke, R. C.: Biopsy of Kidney in Prone Position , Lancet 1:1047-1049, 1954.Crossref 8. McManus, J. F. A.: Histological Demonstration of Mucin After Periodic Acid , Nature (Lond.) 158:202, 1946.Crossref 9. Jones, D. V. Nephrotic Glomerulonephritis , Amer. J. Path. 33:313-329, 1957. 10. Latta, H.: Electron Microscopic Studies of Renal Diseases , Calif. Med. 93:272-287, 1960. 11. Folli, G.; Pollak, V. E.; Reid, R. T.; Pirani, C. L., and Kark, R. M.: Electron Microscopic Studies of Reversible Glomerular Lesions in the Adult Nephrotic Syndrome , Ann. Intern. Med. 49: 775-795, 1958.Crossref 12. MacDonald, M. K.; Lambie, A. T., and Robson, J. S.: Resolution of Glomerular Lesions in the Nephrotic Syndrome Treated with Cortisone: Electron Microscopic Studies in an Adult Case , Scot. Med. J. 4:415-421, 1959. 13. Robbins, S. L.: Textbook of Pathology , Philadelphia, W. B. Saunders Company, 1957. 14. Muehrcke, R. C.; Kark, R. M.; Pirani, C. L., and Pollak, V. E.: Lupus Nephritis: Clinical and Pathological Studies Based on Renal Biopsies , Medicine (Balt.) 36:1-145, 1957. 15. Soffer, L. J.; Southren, A. L.; Weiner, H. E., and Wolf, R. L.: Renal Manifestations of Systemic Lupus Erythematosus: A Clinical and Pathologic Study of 96 Cases , Ann. Intern. Med. 54:215-228, 1961.Crossref 16. Farquhar, M. G.; Vernier, R. L., and Good, R. A.: An Electron Microscope Study of the Glomerulus in Nephrosis, Glomerulonephritis and Lupus Erythematosus , J. Exp. Med. 106:649-660, 1957.Crossref 17. Farquhar, M. G.; Hopper, J., Jr., and Moon, H. D.: Diabetic Glomerulosclerosis: Electron and Light Microscopic Studies , Amer. J. Path. 35: 721-753, 1959. 18. Daysog, A., Jr.; Dobson, H. L., and Brennan, J. C.: Renal Glomerular and Vascular Lesions in Prediabetes and in Diabetes Mellitus: A Study Based on Renal Biopsies , Ann. Intern. Med. 54: 672-684, 1961.Crossref 19. Mautner, W.; Grishman, E., and Churg, J.: Electron Microscopic Studies of Diabetic Nephropathy , Abstract, J. Mount Sinai Hosp., N.Y. 28:504, 1961. 20. Movat, H. Z.: The Fine Structure of the Glomerulus in Amyloidosis , A.M.A. Arch. Path. 69:323-332, 1960. 21. Cohen, A. S., and Calkins, E.: A Study of the Fine Structure of the Kidney in Casein-Induced Amyloidosis in Rabbits , J. Exp. Med. 112: 479-490, 1960.Crossref 22. Spargo, B.; McCartney, C. P., and Win-/ miller, R.: Glomerular Capillary Endotheliosis in Toxemia of Pregnancy , A.M.A. Arch. Path. 68: 593-599, 1959. 23. Mautner, W.;;Altcheck, A.;;Churg, J., and rishman, E.: Electron Microscopic Studies of Renal Biopsies in Preeclampsia ;; Abstract, J. Mount Sinai Hosp.N.Y. 27:374-375, 1960. 24. Hopper,J., Jr.;;Farquhar, M.G.;;Yamauchi, H.; Moon,H.;.D., and Page, E.W.:: Renal Lesions in Pregnancy , Obstet. Gynec.(N.Y.) 17: 71-293, 1961. 25. Joekes, A.M.;;Heptinstall, R.H., and Porter, K. A.: The Nephrotic Syndrome , Quart. J. Med. 7:495-516, 1958. 26. Churg, J.;;Grishman, E., and Mautner, W.:: Nephrotoxic Serum Nephritis in the Rat , Amer. J. Path. 37:729-749, 1960. 27. Tareev, E.M.:: Nephritis , Moscow,Medgiz, 1958. 28. James, J.A., and Ashworth, C. T: Some Features of Glomerular Filtration and Permeability Revealed by Electron Microscopy After Intraperitoneal Injection of Dextran in Rats , Amer. J. Path. 38:515-525, 1961. 29. Hall, B. V.: Renal Filtration and Ultramicroscopic Structure of the Glomerulus ; Abstract, Fed. Proc. 12:467-468, 1953. 30. Spargo, B.: Personal communication to the author. 31. Squire, J. R.: Functional Pathology of the Nephrotic Syndrome , in Recent Advances in Renal Diseases , Philadelphia, J. B. Lippincott Company, 1961. 32. Post, R. S.: The Effects on Glomerular Structure of Proteinuria Induced in Normal Rats Determined by Electron Microscopy , Proc. 11th Annual Conference on the Nephrotic Syndrome , National Kidney Disease Federation, (Oct. 15) -17, 1959, pp. 222-228. 33. Farquhar, M. G.: Review of Normal and Pathologic Glomerular Ultrastructure , Proc. 10th Annual Conference on the Nephrotic Syndrome , National Kidney Disease Federation, (Nov. 6) -8, 1958, pp. 2-25. 34. Spargo, B.; Blozis, G.; Rowley, D., and Fitch, F.: Lesions of Separate Glomerular Components Characteristic of Specific Disorders Resulting in the Nephrotic Syndrome , read before a meeting of the American Association of Pathologists and Bacteriologists, Chicago, April, 1961 . 35. Majno, G.: The Vascular Injury of Acute Inflammation: Contributions of the Electron Microscope , read before a meeting of the American Association of Pathologists and Bacteriologists, Chicago, April, 1961 . 36. Mellors, R. C., and Ortega, L. G.: New Observations on the Pathogenesis of Glomerulonephritis, Lipid Nephrosis, Periarteritis Nodosa, and Secondary Amyloidosis in Man , Amer. J. Path. 32:455-499, 1956. 37. Freedman, P.; Peters, J. H., and Kark, R. M.: Localization of Gamma Globulin in the Diseased Kidney , A.M.A. Arch. Intern. Med. 105: 524-535, 1960.Crossref 38. Paronetto, F.: Personal communication to the author. 39. Dixon, F. J.; Feldman, J. D., and Vasquez, J. J.: Experimental Glomerulonephritis , J. Exp. Med. 113:899-920, 1961.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Structure of Glomerular Capillaries in Proteinuria

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American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1962.03620130099011
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Abstract

Abstract The appearance of large quantities of protein in the urine has long been associated with changes in the renal architecture, although the precise lesion or lesions responsible for this abnormality are not clearly understood. Normally some protein is filtered at the glomerulus and reabsorbed by the tubules. Several investigators have therefore suggested that urinary protein loss is due to failure of the tubular reabsorptive mechanism.1 The majority, however, has attributed the development of proteinuria to increased permeability of glomerular capillaries to plasma proteins.2 Before the advent of electron microscopy, those who held this view could correlate proteinuria only with a general disturbance of the glomerulus, as seen in acute or chronic glomerulonephritis or in diabetic glomerulosclerosis. Changes in the capillary walls, often observed with a light microscope, proved difficult to study and to evaluate.3,4 The application of electron microscopy to biopsy specimens permitted much better visualization of References 1. Freeman, T., and Joekes, A. M.: Nephrotic Proteinuria: A Tubular Lesion? Acta Med. Scand. 157:43-50, 1957.Crossref 2. Derow, H. A.: The Nephrotic Syndrome , New Engl. J. Med. 258:77-82; 124-129, 1958.Crossref 3. Bell, E. T.: Renal Diseases , Ed. 2, Philadelphia, Lea & Febiger, 1950. 4. Churg, J., and Grishman, E.: Subacute Glomerulonephritis , Amer. J. Path. 35:25-45, 1959. 5. Farquhar, M. G.; Vernier, R. L., and Good, R. A.: Studies on Familial Nephrosis , Amer. J. Path. 33:791-817, 1957. 6. Spiro, D.: The Structural Basis of Proteinuria in Man , Amer. J. Path. 35:47-73, 1959. 7. Kark, R. M., and Muehrcke, R. C.: Biopsy of Kidney in Prone Position , Lancet 1:1047-1049, 1954.Crossref 8. McManus, J. F. A.: Histological Demonstration of Mucin After Periodic Acid , Nature (Lond.) 158:202, 1946.Crossref 9. Jones, D. V. Nephrotic Glomerulonephritis , Amer. J. Path. 33:313-329, 1957. 10. Latta, H.: Electron Microscopic Studies of Renal Diseases , Calif. Med. 93:272-287, 1960. 11. Folli, G.; Pollak, V. E.; Reid, R. T.; Pirani, C. L., and Kark, R. M.: Electron Microscopic Studies of Reversible Glomerular Lesions in the Adult Nephrotic Syndrome , Ann. Intern. Med. 49: 775-795, 1958.Crossref 12. MacDonald, M. K.; Lambie, A. T., and Robson, J. S.: Resolution of Glomerular Lesions in the Nephrotic Syndrome Treated with Cortisone: Electron Microscopic Studies in an Adult Case , Scot. Med. J. 4:415-421, 1959. 13. Robbins, S. L.: Textbook of Pathology , Philadelphia, W. B. Saunders Company, 1957. 14. Muehrcke, R. C.; Kark, R. M.; Pirani, C. L., and Pollak, V. E.: Lupus Nephritis: Clinical and Pathological Studies Based on Renal Biopsies , Medicine (Balt.) 36:1-145, 1957. 15. Soffer, L. J.; Southren, A. L.; Weiner, H. E., and Wolf, R. L.: Renal Manifestations of Systemic Lupus Erythematosus: A Clinical and Pathologic Study of 96 Cases , Ann. Intern. Med. 54:215-228, 1961.Crossref 16. Farquhar, M. G.; Vernier, R. L., and Good, R. A.: An Electron Microscope Study of the Glomerulus in Nephrosis, Glomerulonephritis and Lupus Erythematosus , J. Exp. Med. 106:649-660, 1957.Crossref 17. Farquhar, M. G.; Hopper, J., Jr., and Moon, H. D.: Diabetic Glomerulosclerosis: Electron and Light Microscopic Studies , Amer. J. Path. 35: 721-753, 1959. 18. Daysog, A., Jr.; Dobson, H. L., and Brennan, J. C.: Renal Glomerular and Vascular Lesions in Prediabetes and in Diabetes Mellitus: A Study Based on Renal Biopsies , Ann. Intern. Med. 54: 672-684, 1961.Crossref 19. Mautner, W.; Grishman, E., and Churg, J.: Electron Microscopic Studies of Diabetic Nephropathy , Abstract, J. Mount Sinai Hosp., N.Y. 28:504, 1961. 20. Movat, H. Z.: The Fine Structure of the Glomerulus in Amyloidosis , A.M.A. Arch. Path. 69:323-332, 1960. 21. Cohen, A. S., and Calkins, E.: A Study of the Fine Structure of the Kidney in Casein-Induced Amyloidosis in Rabbits , J. Exp. Med. 112: 479-490, 1960.Crossref 22. Spargo, B.; McCartney, C. P., and Win-/ miller, R.: Glomerular Capillary Endotheliosis in Toxemia of Pregnancy , A.M.A. Arch. Path. 68: 593-599, 1959. 23. Mautner, W.;;Altcheck, A.;;Churg, J., and rishman, E.: Electron Microscopic Studies of Renal Biopsies in Preeclampsia ;; Abstract, J. Mount Sinai Hosp.N.Y. 27:374-375, 1960. 24. Hopper,J., Jr.;;Farquhar, M.G.;;Yamauchi, H.; Moon,H.;.D., and Page, E.W.:: Renal Lesions in Pregnancy , Obstet. Gynec.(N.Y.) 17: 71-293, 1961. 25. Joekes, A.M.;;Heptinstall, R.H., and Porter, K. A.: The Nephrotic Syndrome , Quart. J. Med. 7:495-516, 1958. 26. Churg, J.;;Grishman, E., and Mautner, W.:: Nephrotoxic Serum Nephritis in the Rat , Amer. J. Path. 37:729-749, 1960. 27. Tareev, E.M.:: Nephritis , Moscow,Medgiz, 1958. 28. James, J.A., and Ashworth, C. T: Some Features of Glomerular Filtration and Permeability Revealed by Electron Microscopy After Intraperitoneal Injection of Dextran in Rats , Amer. J. Path. 38:515-525, 1961. 29. Hall, B. V.: Renal Filtration and Ultramicroscopic Structure of the Glomerulus ; Abstract, Fed. Proc. 12:467-468, 1953. 30. Spargo, B.: Personal communication to the author. 31. Squire, J. R.: Functional Pathology of the Nephrotic Syndrome , in Recent Advances in Renal Diseases , Philadelphia, J. B. Lippincott Company, 1961. 32. Post, R. S.: The Effects on Glomerular Structure of Proteinuria Induced in Normal Rats Determined by Electron Microscopy , Proc. 11th Annual Conference on the Nephrotic Syndrome , National Kidney Disease Federation, (Oct. 15) -17, 1959, pp. 222-228. 33. Farquhar, M. G.: Review of Normal and Pathologic Glomerular Ultrastructure , Proc. 10th Annual Conference on the Nephrotic Syndrome , National Kidney Disease Federation, (Nov. 6) -8, 1958, pp. 2-25. 34. Spargo, B.; Blozis, G.; Rowley, D., and Fitch, F.: Lesions of Separate Glomerular Components Characteristic of Specific Disorders Resulting in the Nephrotic Syndrome , read before a meeting of the American Association of Pathologists and Bacteriologists, Chicago, April, 1961 . 35. Majno, G.: The Vascular Injury of Acute Inflammation: Contributions of the Electron Microscope , read before a meeting of the American Association of Pathologists and Bacteriologists, Chicago, April, 1961 . 36. Mellors, R. C., and Ortega, L. G.: New Observations on the Pathogenesis of Glomerulonephritis, Lipid Nephrosis, Periarteritis Nodosa, and Secondary Amyloidosis in Man , Amer. J. Path. 32:455-499, 1956. 37. Freedman, P.; Peters, J. H., and Kark, R. M.: Localization of Gamma Globulin in the Diseased Kidney , A.M.A. Arch. Intern. Med. 105: 524-535, 1960.Crossref 38. Paronetto, F.: Personal communication to the author. 39. Dixon, F. J.; Feldman, J. D., and Vasquez, J. J.: Experimental Glomerulonephritis , J. Exp. Med. 113:899-920, 1961.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1962

References