Bohman S O, Jaremko G, Bohlin A B, Berg U
Kidney Int. 1984 Apr;25(4):696-700. doi: 10.1038/ki.1984.76.
Reduced glomerular filtration rate (GFR), not due to hypovolemia, has been reported in patients in the proteinuric phase of the minimal change nephrotic syndrome (MCNS). A group of children with MCNS was studied to investigate the possible relationship between the fusion of glomerular epithelial foot processes and the reduction in GFR. The degree of foot process fusion was estimated as the harmonic true mean of foot process width and the length density of epithelial slit pores as determined by quantitative electron microscopic stereology. In the patients investigated GFR ranged between 40 and 127 ml/min/1.73 m2 body surface area, the filtration fraction between 6.9 and 22.5%, and the serum albumin concentration between 14 and 46 g/liter. The mean foot process width, which varied between 330 and 870 nm, showed a close correlation with GFR (r = -0.859) and the filtration fraction (r = -0.812), as well as with the serum albumin concentration (r = -0.756). As expected, a reduction of epithelial slit pore length occurred concomitant with the broadening of the foot processes. These results agree with the hypothesis that the reduction in the total length of glomerular epithelial slit pores, due to the fusion of foot processes, results in a reduced glomerular capillary permeability to water and small solutes.
据报道，在微小病变肾病综合征（MCNS）蛋白尿期的患者中，肾小球滤过率（GFR）降低，但并非由于血容量不足所致。对一组MCNS患儿进行了研究，以探讨肾小球上皮足突融合与GFR降低之间的可能关系。通过定量电子显微镜体视学确定，足突融合程度以足突宽度与上皮裂隙孔长度密度的调和真均值来估计。在所研究的患者中，GFR在40至127 ml/min/1.73 m²体表面积之间，滤过分数在6.9%至22.5%之间，血清白蛋白浓度在14至46 g/L之间。平均足突宽度在330至870 nm之间变化，与GFR（r = -0.859）、滤过分数（r = -0.812）以及血清白蛋白浓度（r = -0.756）密切相关。正如预期的那样，上皮裂隙孔长度的减少与足突增宽同时发生。这些结果与以下假设一致，即由于足突融合导致肾小球上皮裂隙孔总长度减少，从而使肾小球毛细血管对水和小分子溶质的通透性降低。
