J Korean Soc Pediatr Nephrol.  2013 Apr;17(1):13-18.

Podocytopathy and Morphologic Changes in Focal Segmental Glomerulosclerosis

Affiliations
  • 1Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. jeong10@yuhs.ac

Abstract

Podocytopathy is glomerular lesions characterized by podocyte injury. It is observed in various glomerular diseases, but minimal change disease and focal segmental glomerulosclerosis (FSGS) are the prototypes. In this review, morphologic features of podocyte injury and subtypes of FSGS will be reviewed briefly. Effacement of podocyte foot processes is the most common feature of podocyte injury. As podocytic injury progresses, intracytoplasmic vacuoles, subpodocytic cyst, detachment of podocytes from the glomerular basement membrane and apoptosis develop. Glomerular capillary loops in epithelium-denuded area undergo capillary collapse. Synechia and hyalinosis may accompany this lesion. To manifest segmental sclerosis, podocyte loss above a threshold level may be required. Injured podocytes can injure neighboring intact podocytes, and thereby spread injury within the same lobule. FSGS can be categorized into five subtypes by morphologic characteristics; not otherwise specified (NOS), perihilar, cellular, tip, and collapsing types. Each subtype has been reported to show different clinical courses and associated conditions, but there are controversies on its significance. With recent progress in the discovery of genetic abnormalities causing FSGS and plasma permeability factors, we expect to unravel pathophysiology of FSGS and to understand histological sequences leading to FSGS in near future.

Keyword

Focal segmental glomerulosclerosis; Morphology; Subtypes

MeSH Terms

Apoptosis
Capillaries
Foot
Glomerular Basement Membrane
Glomerulosclerosis, Focal Segmental
Nephrosis, Lipoid
Permeability
Plasma
Podocytes
Sclerosis
Vacuoles
Glomerulosclerosis, Focal Segmental
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