INTRODUCTION

The primary aim of this study was to investigate the morphological characteristics of podocyte mitochondria in glomerular diseases, and to analyze the correlations between these characteristics and podocyte injury, as well as clinical indicators.

METHODS

This study analyzed renal biopsies from 103 patients with IgA nephropathy (IgAN), minimal change nephropathy (MCN), and idiopathic membranous nephropathy (IMN), alongside 22 controls, using transmission electron microscopy (TEM). Mitochondrial size, shape, density, and subcellular distribution were quantified and correlated with podocyte injury (foot process width, FPW) and clinical parameters.

RESULTS

The results indicated that podocyte mitochondria in patients with glomerular diseases were smaller, rounder, and significantly more numerous, with a more pronounced increase in the region proximal to the glomerular basement membrane (GBM). The FPW indicators revealed that podocyte damage was most severe in the IMN group, followed by the MCN group, and least severe in the IgAN group. Mitochondrial size was negatively correlated with FPW, while mitochondrial density distribution was positively correlated with FPW. In the IgAN group, the morphological characteristics of podocyte mitochondria were statistically correlated with clinical parameters, including age, estimated glomerular filtration rate (eGFR), albumin levels, and proteinuria.

CONCLUSION

Podocytes in patients with glomerular diseases exhibit significant mitochondrial morphological abnormalities, including mitochondrial fragmentation, increased fission, and altered distribution. Furthermore, in IgAN, mitochondrial morphological abnormalities and their redistribution in podocytes are significantly correlated with podocyte injury-primarily manifested as foot process effacement-and with the severity of the disease.