It was shown that loss of sulfated proteoglycans and anionic regions in the basal membrane of the glomerulus and the mesangial
mat rix caused excess accumulation of proteoglycans such as chondroitin sulphate and dermatan sulphate in these areas.3 This causes a decrease in charge-dependent renal selectivity and an increase in the thickness of the basal membrane.
Light microscopy indicated a proliferation of mesangial
cells and mesangial
matrix, with only a minority of tissue samples showing segmental sclerosis.
Histopathology showed presence of fetal glomeruli & mild mesangial
matrix accentuation in one glomerulus.
Histopathological changes like glomerular adhesions, glomerular crescent formation, tubular necrosis, tubular vacuolar degeneration, mesangial
hypercellularity, interstitial fibrosis, vascular sclerosis, capillary wall thickness, tubular cast and interstitial inflammation.
In the glomeruli, this receptor seems to be present in all major renal cells, including mesangial
cells, endothelial cells, and podocytes.
But in our case due to the absence of hematuria and the classical features such as mesangial
segmental hypercellularity, increased mesangial
matrix and granular IgA deposits in the mesangium, the possibility of IgA nephropathy was ruled out.
Glomerular global sclerosis was observed in one glomerulus and increased mesangial
cells and matrix, and glomerular hypertrophy in other glomerulus.
The light microscopic examination of a kidney biopsy revealed two out of 15 glomeruli with global sclerosis, a diffuse endocapillary and mesangial
proliferative pattern without crescents, and 30% interstitial fibrosis and tubular atrophy.
Renal biopsy showed mild focal glomerular mesangial
Several glomeruli showed focal and segmental increase in mesangial
cellularity and sclerosis.
CKD is defined clinically by prolonged and progressive loss of kidney function measured by a declined glomerular filtration rate (GFR) and the presence of albuminuria with pathological findings of mesangial
expansion, inflammation, and renal fibrosis .