Figure 7.
Lysosomal changes are more frequent but not restricted to renal biopsies from patients with Sym-CKDu. (a) Lysosomes with electron-dense aggregates were seen in proximal tubules and (b) occurred in a small round (black arrowheads) and/or (c) dysmorphic shape (white arrowhead). (d) Evaluation of the percentage of cases with lysosomes with electron-dense aggregates irrespective of shape and size or (e) restricted to dysmorphic lysosomes in biopsies from the Sym-CKDu and the control cohort with different renal diseases. (f) n of dysmorphic lysosomes with electron-dense aggregates per 400 μm2 in biopsies from Sym-CKDu and the control cohort with different renal diseases. (g,h) Representative electron microscopic pictures of tubuli seen in biopsies from patients with IgA nephropathy showing small round (black arrowheads) and dysmorphic (white arrowheads) lysosomes with electron-dense aggregates. BB, brush border; CKDu, chronic kidney disease of uncertain etiology; DN, diabetic nephropathy; FSGS, focal segmental glomerulosclerosis; IgAN, IgA nephropathy; KTx, kidney transplantation; M, mitochondria; MCGP, minimal change glomerulopathy; NM, nephropathy; RBC, red blood cell; TBM, tubular basement membrane. ∗∗∗P < 0.001, ∗∗ P < 0.01, ∗ P < 0.05 vs. Sym-CKDu group as assessed by Kruskal-Wallis test followed by Dunn’s multiple comparison test.