Rapid assessment of microbiological purity of dialysis water: the promise of solid-phase cytometry assessment and the epifluorescence microscopy method

Abstract

assessment of glomerular density) and lower glomerular density score. Interestingly, glomeruli with segmental sclerosis, included in the glomerular density metric, were also more common in the group with lower glomerular density (2 versus 0.2%.) The infrequent and highly variable presence of segmental sclerosis likely underlies the lack of statistically significant difference in sclerosis between groups with higher versus lower glomerular density. Exclusion of patients with decreased renal function at time of biopsy likely explains why this lesion was so rare. Not surprisingly, interstitial fibrosis >10% was linked to lower glomerular density than interstitial fibrosis < 10%, with similar distinction when the interstitial fibrosis threshold was set at 20%. Yet, these variables of interstitial fibrosis/tubular atrophy did not predict outcome in univariate or multivariate analysis nor did global sclerosis per se .T he robust predictive value of the simple metric of glomerular density thus may have complex underlying pathophysiological mechanisms that may not be easy to unravel. Nonetheless, in this group of patients who were indistinguishable at the onset, this information, in conjunction with a response of proteinuria to therapeutic intervention, significantly contributed to identification of patients with poor prognosis. Regardless of the causality of the decrease in number of glomeruli relative to cortical area, this simple technique may offer additional guidance to identify patients in whom we should target our most aggressive interventions.