Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors

Andrew D Rule, Merfake H. Semret, Hatem Amer, Lynn D. Cornell, Sandra J Taler, John C Lieske, L. Joseph Melton, Mark D Stegall, Stephen C Textor, Walter K Kremers, Lilach O Lerman

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Abstract

OBJECTIVE: To test the hypothesis that kidney function and metabolic risk factors are associated with glomerular density on renal biopsy samples from healthy adults. PATIENTS AND METHODS: This study compared glomerular density with predonation kidney function, blood pressure, and metabolic risk factors in living kidney donors at Mayo Clinic in Rochester, MN, from May 10, 1999, to February 4, 2009. During implantation of the kidney allograft, an 18-gauge core needle biopsy sample of the renal cortex was obtained, sectioned, and examined by pathologists. Glomerular density was determined by the number of glomeruli (normal and sclerotic) divided by area of cortex. RESULTS: The study sample of 1046 kidney donors had a mean of 21 glomeruli (0.8 sclerotic glomeruli) and a glomerular density of 2.3 glomeruli per square millimeter. In a subset of 54 donors, glomerular density inversely correlated with the mean glomerular area (rs=-0.28). Independent predictors of decreased glomerular density were older age, increased glomerular filtration rate, family history of end-stage renal disease, increased serum uric acid, and increased body mass index. Increased urine albumin excretion, hypertension, decreased high-density lipoprotein cholesterol, and metabolic syndrome were also associated with decreased glomerular density after age-sex adjustment. These associations were not explained by the presence of glomerulosclerosis, tubular atrophy, interstitial fibrosis, or arteriosclerosis on the renal biopsy sample. In older donors, decreased glomerular density was attenuated by an increased prevalence of glomerulosclerosis and tubular atrophy. CONCLUSION: Decreased glomerular density is associated with many different kidney function and metabolic risk factors among relatively healthy adults and may represent an early state of increased risk of parenchymal injury.

Original languageEnglish (US)
Pages (from-to)282-290
Number of pages9
JournalMayo Clinic Proceedings
Volume86
Issue number4
DOIs
StatePublished - 2011

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Living Donors
Kidney
Biopsy
Tissue Donors
Atrophy
Kidney Function Tests
Large-Core Needle Biopsy
Social Adjustment
Arteriosclerosis
Uric Acid
Glomerular Filtration Rate
HDL Cholesterol
Chronic Kidney Failure
Allografts
Albumins
Body Mass Index
Fibrosis
Urine
Blood Pressure
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors",
abstract = "OBJECTIVE: To test the hypothesis that kidney function and metabolic risk factors are associated with glomerular density on renal biopsy samples from healthy adults. PATIENTS AND METHODS: This study compared glomerular density with predonation kidney function, blood pressure, and metabolic risk factors in living kidney donors at Mayo Clinic in Rochester, MN, from May 10, 1999, to February 4, 2009. During implantation of the kidney allograft, an 18-gauge core needle biopsy sample of the renal cortex was obtained, sectioned, and examined by pathologists. Glomerular density was determined by the number of glomeruli (normal and sclerotic) divided by area of cortex. RESULTS: The study sample of 1046 kidney donors had a mean of 21 glomeruli (0.8 sclerotic glomeruli) and a glomerular density of 2.3 glomeruli per square millimeter. In a subset of 54 donors, glomerular density inversely correlated with the mean glomerular area (rs=-0.28). Independent predictors of decreased glomerular density were older age, increased glomerular filtration rate, family history of end-stage renal disease, increased serum uric acid, and increased body mass index. Increased urine albumin excretion, hypertension, decreased high-density lipoprotein cholesterol, and metabolic syndrome were also associated with decreased glomerular density after age-sex adjustment. These associations were not explained by the presence of glomerulosclerosis, tubular atrophy, interstitial fibrosis, or arteriosclerosis on the renal biopsy sample. In older donors, decreased glomerular density was attenuated by an increased prevalence of glomerulosclerosis and tubular atrophy. CONCLUSION: Decreased glomerular density is associated with many different kidney function and metabolic risk factors among relatively healthy adults and may represent an early state of increased risk of parenchymal injury.",
author = "Rule, {Andrew D} and Semret, {Merfake H.} and Hatem Amer and Cornell, {Lynn D.} and Taler, {Sandra J} and Lieske, {John C} and Melton, {L. Joseph} and Stegall, {Mark D} and Textor, {Stephen C} and Kremers, {Walter K} and Lerman, {Lilach O}",
year = "2011",
doi = "10.4065/mcp.2010.0821",
language = "English (US)",
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pages = "282--290",
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TY - JOUR

T1 - Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors

AU - Rule, Andrew D

AU - Semret, Merfake H.

AU - Amer, Hatem

AU - Cornell, Lynn D.

AU - Taler, Sandra J

AU - Lieske, John C

AU - Melton, L. Joseph

AU - Stegall, Mark D

AU - Textor, Stephen C

AU - Kremers, Walter K

AU - Lerman, Lilach O

PY - 2011

Y1 - 2011

N2 - OBJECTIVE: To test the hypothesis that kidney function and metabolic risk factors are associated with glomerular density on renal biopsy samples from healthy adults. PATIENTS AND METHODS: This study compared glomerular density with predonation kidney function, blood pressure, and metabolic risk factors in living kidney donors at Mayo Clinic in Rochester, MN, from May 10, 1999, to February 4, 2009. During implantation of the kidney allograft, an 18-gauge core needle biopsy sample of the renal cortex was obtained, sectioned, and examined by pathologists. Glomerular density was determined by the number of glomeruli (normal and sclerotic) divided by area of cortex. RESULTS: The study sample of 1046 kidney donors had a mean of 21 glomeruli (0.8 sclerotic glomeruli) and a glomerular density of 2.3 glomeruli per square millimeter. In a subset of 54 donors, glomerular density inversely correlated with the mean glomerular area (rs=-0.28). Independent predictors of decreased glomerular density were older age, increased glomerular filtration rate, family history of end-stage renal disease, increased serum uric acid, and increased body mass index. Increased urine albumin excretion, hypertension, decreased high-density lipoprotein cholesterol, and metabolic syndrome were also associated with decreased glomerular density after age-sex adjustment. These associations were not explained by the presence of glomerulosclerosis, tubular atrophy, interstitial fibrosis, or arteriosclerosis on the renal biopsy sample. In older donors, decreased glomerular density was attenuated by an increased prevalence of glomerulosclerosis and tubular atrophy. CONCLUSION: Decreased glomerular density is associated with many different kidney function and metabolic risk factors among relatively healthy adults and may represent an early state of increased risk of parenchymal injury.

AB - OBJECTIVE: To test the hypothesis that kidney function and metabolic risk factors are associated with glomerular density on renal biopsy samples from healthy adults. PATIENTS AND METHODS: This study compared glomerular density with predonation kidney function, blood pressure, and metabolic risk factors in living kidney donors at Mayo Clinic in Rochester, MN, from May 10, 1999, to February 4, 2009. During implantation of the kidney allograft, an 18-gauge core needle biopsy sample of the renal cortex was obtained, sectioned, and examined by pathologists. Glomerular density was determined by the number of glomeruli (normal and sclerotic) divided by area of cortex. RESULTS: The study sample of 1046 kidney donors had a mean of 21 glomeruli (0.8 sclerotic glomeruli) and a glomerular density of 2.3 glomeruli per square millimeter. In a subset of 54 donors, glomerular density inversely correlated with the mean glomerular area (rs=-0.28). Independent predictors of decreased glomerular density were older age, increased glomerular filtration rate, family history of end-stage renal disease, increased serum uric acid, and increased body mass index. Increased urine albumin excretion, hypertension, decreased high-density lipoprotein cholesterol, and metabolic syndrome were also associated with decreased glomerular density after age-sex adjustment. These associations were not explained by the presence of glomerulosclerosis, tubular atrophy, interstitial fibrosis, or arteriosclerosis on the renal biopsy sample. In older donors, decreased glomerular density was attenuated by an increased prevalence of glomerulosclerosis and tubular atrophy. CONCLUSION: Decreased glomerular density is associated with many different kidney function and metabolic risk factors among relatively healthy adults and may represent an early state of increased risk of parenchymal injury.

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DO - 10.4065/mcp.2010.0821

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JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

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