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Loss of Anionic Sites from the Glomerular Basement Membrane in Human Glomerulonephritides

Changes in glomerular anionic sites were analyzed in 31 patients with various types of glomerulonephritis using the high iron diamine thiocarbohydrazide‐silver proteinate method. On the basis of the degree of proteinuria at the time of biopsy, the patients were divided into 3 groups as follows: Group 1, less than 10 mg/kg/24 h; Group 2, 10‐50 mg/kg/24 h; Group 3, more than 50 mg/kg/24 h. The number of glomerular anionic sites per 300 nm length of the lamina rara externa was 16.20±3.37 in Group 1, 12.19±3.42 in Group 2 and 9.97±2.51 in Group 3. Moreover, smaller and irregularly distributed anionic sites, and a greater loss of anionic sites in the paramesangial region were observed in Groups 2 and 3. On the other hand, there was no significant correlation between the mesangial sclerosis index and the number of anionic sites (r =−0.40) in patients with IgA nephropathy (9 cases) and nephritis of Henoch‐Schönlein purpura (6 cases). These results suggest that the proteinuria seen in various types of glomerulonephritis is related to the loss of glomerular anionic sites, i.e., dysfunction of the charge‐selective barrier. Acta Pathol Jpn 40: 172‐180, 1990.