Scanning electron microscope (SEM) is not routinely used in diagnostic renal pathology. However, SEM can provides insight into pathophysiology of certain renal disease. Progression of diabetic nephropathy is clinically measured by amount of albuminuria, from microalbuminuria in the early to overt proteinuria in late disease. By using SEM, Conti et al. demonstrated that the state of proteinuria reflect morphological alteration of visceral epithelial cells (podocytes). Biopsy in patient with early DN who had no microalbuminuria showed largely intact podocytes without injury. Patients with advanced DN showed near total podocyte loss.
https://doi.org/10.1038/s41598-018-23244-2
