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Standardization of measurement and determination of normal glomerular basement membrane thickness at Department of Pathology and Cytology, Dubrava University Hospital, Zagreb

Objective. Glomerular basement membrane (GBM) thickness depends on multiple factors and many authors emphasize need for referential span of normal GBM thickness for each laboratory. Methods. We have applied modification of the direct measurement/arithmetic mean method to measure GBM thickness on digital EM photographies (30 measurements for each biopsy) using iTEM software (Olympus Soft Imaging Solutions GmbH). Position of measurements in capillary loops was determined similarly as described by Haas (Arch Pathol Lab Med, 2009). Results. We obtained mean ±SD values for the normal GBM thickness of adult males and females of 340±36 nm and 301±44 nm. These values were based on average GBM thickness for each of 23 males and 22 females, aged 19 to 84 years, with minimal change disease, acute interstitial nephritis, normal renal parenchyma or acute tubular injury. Exclusion criteria were hematuria and diabetes mellitus. We defined normal ranges for each gender (268-412 nm for males, 213-389 for females), as being within 2 SD of these means. Conclusion. With this research we have standardized method for GBM thickness measurement and defined referential span of normal GBM thickness for our laboratory. These results are crucial for accurate diagnosis of disorders characterized with structural changes of GBM.

Glomerular basement membrane ; electron microscopy

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