Nailfold capillaroscopic changes in patients with glomerular diseases

Abstract

Introduction and objectives

Glomerulonephritis is a heterogenous group of diseases which is diagnosed mainly by renal biopsy. This study aims to assess nailfold capillaroscopic changes in patients with glomerular diseases.

Patients and methods

This study was conducted on 50 patients with glomerular disease confirmed by renal biopsy and 50 age and sex matched healthy controls. Clinical, laboratory evaluation and nailfold capillaroscopic examination were done for all participants.

Results

Lupus nephritis was the most common pathological type among glomerulonephritis group [17 (34%)], followed by focal segmental glomerulosclerosis [9 (18%)]. Tortuous capillaries were significantly higher in patients with primary glomerular diseases compared to healthy persons (92.9% vs 58%, P < 0.001). The diameter was significantly lower in patients with primary glomerular diseases compared to healthy control group (15.6 μm vs 18.9 μm, P = 0.001). Subpapillary venous plexus (28.6% vs 6%, P = 0.02) and capillary microhemorrhage (32% vs 0%, P < 0.001) were significantly more frequent in patients with primary glomerular diseases compared to the control group. Patients with lupus nephritis had higher capillary diameter (19.5 vs 15.6 μm, P = 0.02), width (55.6 vs 44 μm, P = 0.003) and microhemorrhage (64.7% vs 32%, P = 0.03) compared to patients with primary glomerulonephritis. There was a statistically significant difference as regard diameter (P = 0.005) and length (P = 0.02) between different classes of lupus nephritis.

Conclusion

More tortious capillaries and lower capillary diameter were found in patients with primary glomerular disease compared to healthy persons. Lupus nephritis patients had more dilated capillaries and more capillary microhemorrhage compared to primary glomerulonephritis patients.