1. The spectrum of kidney biopsy findings in patients with morbid obesity
Hae-Yoon Grace Choung, Andrew S. Bomback, M. Barry Stokes, Dominick Santoriello, Eric S. Campenot, Ibrahim Batal, Glen S. Markowitz, Vivette D. D’Agati 
Kidney International 
Volume 95, Issue 3, Pages (March 2019)
DOI: /j.kint
Copyright © 2019 International Society of Nephrology Terms and Conditions

2. Kidney International 2019 95, 647-654DOI: (10.1016/j.kint.2018.11.026)
Copyright © 2019 International Society of Nephrology Terms and Conditions

3. Figure 1
Examples of biopsy findings in morbidly obese patients. (a) Obesity-related glomerulopathy (ORG) alone showing typical glomerulomegaly and perihilar focal segmental sclerosis with focal tubular atrophy and interstitial fibrosis (periodic acid–Schiff [PAS], original magnification ×200). (b) ORG alone with marked glomerular hypertrophy. The glomerular capillary luminal diameters appear increased and the glomerular basement membranes are unremarkable (PAS, original magnification ×400). (c) ORG alone showing a discrete perihilar lesion of sclerosis and hyalinosis involving the vascular pole of a hypertrophied glomerulus (PAS, original magnification ×400). (d) Acute postinfectious glomerulonephritis with no evidence of ORG. The glomerulus is engorged with infiltrating neutrophils but the glomerular size is not visibly increased (hematoxylin and eosin, original magnification ×400). (e) ORG alone has relatively preserved foot processes with effacement involving less than 20% of the total glomerular capillary surface area (electron micrograph, original magnification ×6000). (f) Antineutrophil cytoplasmic antibody–associated pauci-immune glomerulonephritis with no evidence of ORG. The glomerulus displays segmental fibrinoid necrosis with the rupture of the glomerular basement membrane and a segmental cellular crescent, but the glomerular size is not visibly increased (Jones methenamine silver, original magnification ×400). To optimize viewing of this image, please see the online version of this article at
Kidney International  , DOI: ( /j.kint )
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4. Figure 2
Elucidating the presence or absence of concomitant obesity-related glomerulopathy in biopsies with other renal lesions. (a) Minimal change disease with no evidence of obesity-related glomerulopathy (ORG): the glomerulus appears normal in size and cellularity (hematoxylin and eosin, original magnification ×400). (b) Minimal change disease with no evidence of ORG: the same case as in part (a) has diffuse foot process effacement with no evidence of glomerular basement membrane deposits (electron micrograph, original magnification ×6000). (c) Minimal change disease with ORG (glomerulomegaly alone): the glomerulus is enlarged with a normocellular tuft. The biopsy showed similar diffuse glomerulomegaly but no lesions of segmental sclerosis (Jones methenamine silver, original magnification ×400). (d) Minimal change disease with ORG: the same biopsy as in part (c) has marked diffuse foot process effacement with microvillous transformation of the podocytes (electron micrograph, original magnification ×8000). (e) Diabetic nephropathy with ORG: in addition to the nodules of diabetic glomerulosclerosis, this enlarged glomerulus contains a perihilar lesion of segmental sclerosis and hyalinosis. Such perihilar lesions were identified involving 8 of 12 glomeruli sampled by light microscopy (periodic acid–Schiff [PAS], original magnification ×400). (f) Diabetic nephropathy with ORG: the same case as in part (e) shows a similar perihilar lesion of segmental sclerosis and hyalinosis and capsular adhesion superimposed on changes of nodular diabetic glomerulosclerosis (PAS, original magnification ×400). To optimize viewing of this image, please see the online version of this article at
Kidney International  , DOI: ( /j.kint )
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