Glomerular basement membrane thickness in minimal change disease. The ultrastructural quantitative study.

Fifteen renal biopsy specimens from adult patients with minimal change disease (MCD) for whom both light and electron microscopy as well as immunofluorescence microscopy and full clinical data were available were examined quantitatively and compared with six normal controls. The electron micrographs of the glomeruli were scanned in Primax flatbed A4 scanner and then morphometric investigations were performed by means of a computer image analysis system to compare glomerular basement membrane (GBM) thickness and to study whether this parameter could correlate with the degree of proteinuria. The study revealed that the mean GBM thickness was lower in MCD patients as compared with normal controls (299.2 nm versus 338.8 nm), but this difference did not reach statistical significance. Interestingly, the present investigations showed that the GBM thickness tended to be related directly to proteinuria and not inversely as it might be expected, but this relationship was not significant, either. In conclusion, we can confirm the tendency to GBM thinning in adult MCD patients. It should be also noted, that GBM thinning did not increase the degree of proteinuria in these cases.