Spectrum of Renal Biopsy findings in TRIDENT Cohort
Jackson, Casey   (University of Pennsylvania)
Mentor: Susztak, Katalin
As more patients are diagnosed with diabetes mellitus, the prevalence of diabetic kidney disease (DKD) increases, and more renal biopsies are performed. However the precise relationship between histological and clinical parameters in DKD is incompletely understood. The TRIDENT study enrolls 400 subjects with diabetes who are undergoing clinically indicated renal biopsies and performs multi-omics characterization of subjects to better understand rapid decline in kidney function and proteinuria in patients with DKD. Here, we seek to understand whether podocyte and basement membrane changes correlate with kidney function, degree of albuminuria, and other histopathologic features of diabetic nephropathy using electron micrographs and digital light microscopy slides. I performed a retrospective, quantitative characterization of podocyte foot process morphology using electron micrographs of biopsies in nearly 100 subjects in the TRIDENT study. Podocyte foot process width (FPW) was measured using electron micrographs in ImageJ and calculated: FPW = (p/4) × (SGBM length/Sfoot process). The average FPW was 1.624µm, and the glomerular basement membrane (GBM) average thickness was 773.27µm. The average FPW ranged from 519µm to 4.806µm per patient, and the GBM thickness ranged from 200µm to 3230µm in each patient. We are currently examining the correlations between FPW and proteinuria, FPW and duration of diabetes, and FPW and glomerular filtration rate. These data will inform the extent to which the severity of DN correlates to degree of podocyte foot process injury.