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1 Divisions of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA; Department of Cellular and Molecular Physiology, Stanford University, Stanford, CA, USA
2 Department of Cellular and Molecular Physiology, Stanford University, Stanford, CA, USA
3 Divisions of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA
4 Divisions of Nephrology, Department of Medicine, Stanford University, Stanford, CA, USA; Division of Nephrology, Department of Pediatrics, Stanford University, Stanford, CA, USA
* To whom correspondence should be addressed. E-mail: klemley{at}stanford.edu.
The loss of glomerular visceral epithelial cells (podocytes) has been associated with the development of glomerular sclerosis and loss of renal function. Viability of podocytes recovered from urine of subjects with glomerular disease and of healthy controls was investigated by propidium iodide exclusion and TUNEL staining. Podocyte loss was quantified by cytospin. The growth behavior in culture of urinary cells and their expression of specific markers were examined. The majority of urinary podocytes are viable, although apoptosis occurs in about half of the cells. Patients with active glomerular disease excreted up to 388 podocytes/mg creatinine, whereas healthy controls and patients with quiescent disease generally excreted less than 0.5 podocytes/mg creatinine. The identity of cultured cells was confirmed by their morphology, growth behavior and expression of podocyte-specific markers. The difference in growth behavior between healthy controls and subjects with active glomerular disease suggests that in active disease viable podocytes detach from the glomerular tuft due to local environmental factors rather than defects in the podocytes per se, whereas in healthy individuals mostly senescent podocytes are shed.
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