Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living kidney donors

Hisham E. Elsherbiny, Mariam P Alexander, Walter K Kremers, Walter D. Park, Emilio D. Poggio, Mikel Prieto, John C Lieske, Andrew D Rule

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35 Citations (Scopus)

Abstract

Background and objectives The relationship of kidney function and CKD risk factors to structural changes in the renal parenchyma of normal adults is unclear. This study assessed whether nephron hypertrophy and nephron sclerosis had similar or different associations with kidney function and risk factors. Design, setting, participants, & measurements From 1999 to 2009, 1395 living kidney donors had a core needle biopsy of their donated kidney during transplant surgery. The mean non sclerotic glomerular volume and glomerular density (globally sclerotic and non sclerotic) were estimated using the Weibel and Gomez stereologic methods. All tubules were counted in 1 cm2 of cortex to determine a mean profile tubular area. Nephron hypertrophy was identified by larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density. Nephro sclerosis was identified by higher globally sclerotic glomerular density. Results The mean (6SD) age was 44612 years, 24-hour urine albumin excretion was 567mg, measured GFR was 103617 ml/min per 1.73 m2, uric acid was 5.261.4 mg/dl, and body mass index was 2865 kg/m2. Of the study participants, 43% were men, 11% had hypertension, and 52% had a family history of ESRD. Larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density were correlated. Male sex, higher 24-hour urine albumin excretion, family history of ESRD, and higher body mass index were independently associated with each of these measures of nephron hypertrophy. Higher uric acid, higher GFR, and older age were also independently associated with some of these measures of nephron hypertrophy. Hypertension was not independently associated with measures of nephron hypertrophy. However, hypertension and older age were independently associated with higher globally sclerotic glomerular density. Conclusions Nephron hypertrophy and nephron sclerosis are structural characteristics in normal adults that relate differently to clinical characteristics and may reflect kidney function and risk factors via separate but inter-related pathways.

Original languageEnglish (US)
Pages (from-to)1892-1902
Number of pages11
JournalClinical Journal of the American Society of Nephrology
Volume9
Issue number11
DOIs
StatePublished - 2014

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Living Donors
Nephrons
Hypertrophy
Kidney
Sclerosis
Hypertension
Uric Acid
Chronic Kidney Failure
Albumins
Body Mass Index
Urine
Large-Core Needle Biopsy
Transplants

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

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title = "Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living kidney donors",
abstract = "Background and objectives The relationship of kidney function and CKD risk factors to structural changes in the renal parenchyma of normal adults is unclear. This study assessed whether nephron hypertrophy and nephron sclerosis had similar or different associations with kidney function and risk factors. Design, setting, participants, & measurements From 1999 to 2009, 1395 living kidney donors had a core needle biopsy of their donated kidney during transplant surgery. The mean non sclerotic glomerular volume and glomerular density (globally sclerotic and non sclerotic) were estimated using the Weibel and Gomez stereologic methods. All tubules were counted in 1 cm2 of cortex to determine a mean profile tubular area. Nephron hypertrophy was identified by larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density. Nephro sclerosis was identified by higher globally sclerotic glomerular density. Results The mean (6SD) age was 44612 years, 24-hour urine albumin excretion was 567mg, measured GFR was 103617 ml/min per 1.73 m2, uric acid was 5.261.4 mg/dl, and body mass index was 2865 kg/m2. Of the study participants, 43{\%} were men, 11{\%} had hypertension, and 52{\%} had a family history of ESRD. Larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density were correlated. Male sex, higher 24-hour urine albumin excretion, family history of ESRD, and higher body mass index were independently associated with each of these measures of nephron hypertrophy. Higher uric acid, higher GFR, and older age were also independently associated with some of these measures of nephron hypertrophy. Hypertension was not independently associated with measures of nephron hypertrophy. However, hypertension and older age were independently associated with higher globally sclerotic glomerular density. Conclusions Nephron hypertrophy and nephron sclerosis are structural characteristics in normal adults that relate differently to clinical characteristics and may reflect kidney function and risk factors via separate but inter-related pathways.",
author = "Elsherbiny, {Hisham E.} and Alexander, {Mariam P} and Kremers, {Walter K} and Park, {Walter D.} and Poggio, {Emilio D.} and Mikel Prieto and Lieske, {John C} and Rule, {Andrew D}",
year = "2014",
doi = "10.2215/CJN.02560314",
language = "English (US)",
volume = "9",
pages = "1892--1902",
journal = "Clinical Journal of the American Society of Nephrology",
issn = "1555-9041",
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number = "11",

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T1 - Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living kidney donors

AU - Elsherbiny, Hisham E.

AU - Alexander, Mariam P

AU - Kremers, Walter K

AU - Park, Walter D.

AU - Poggio, Emilio D.

AU - Prieto, Mikel

AU - Lieske, John C

AU - Rule, Andrew D

PY - 2014

Y1 - 2014

N2 - Background and objectives The relationship of kidney function and CKD risk factors to structural changes in the renal parenchyma of normal adults is unclear. This study assessed whether nephron hypertrophy and nephron sclerosis had similar or different associations with kidney function and risk factors. Design, setting, participants, & measurements From 1999 to 2009, 1395 living kidney donors had a core needle biopsy of their donated kidney during transplant surgery. The mean non sclerotic glomerular volume and glomerular density (globally sclerotic and non sclerotic) were estimated using the Weibel and Gomez stereologic methods. All tubules were counted in 1 cm2 of cortex to determine a mean profile tubular area. Nephron hypertrophy was identified by larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density. Nephro sclerosis was identified by higher globally sclerotic glomerular density. Results The mean (6SD) age was 44612 years, 24-hour urine albumin excretion was 567mg, measured GFR was 103617 ml/min per 1.73 m2, uric acid was 5.261.4 mg/dl, and body mass index was 2865 kg/m2. Of the study participants, 43% were men, 11% had hypertension, and 52% had a family history of ESRD. Larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density were correlated. Male sex, higher 24-hour urine albumin excretion, family history of ESRD, and higher body mass index were independently associated with each of these measures of nephron hypertrophy. Higher uric acid, higher GFR, and older age were also independently associated with some of these measures of nephron hypertrophy. Hypertension was not independently associated with measures of nephron hypertrophy. However, hypertension and older age were independently associated with higher globally sclerotic glomerular density. Conclusions Nephron hypertrophy and nephron sclerosis are structural characteristics in normal adults that relate differently to clinical characteristics and may reflect kidney function and risk factors via separate but inter-related pathways.

AB - Background and objectives The relationship of kidney function and CKD risk factors to structural changes in the renal parenchyma of normal adults is unclear. This study assessed whether nephron hypertrophy and nephron sclerosis had similar or different associations with kidney function and risk factors. Design, setting, participants, & measurements From 1999 to 2009, 1395 living kidney donors had a core needle biopsy of their donated kidney during transplant surgery. The mean non sclerotic glomerular volume and glomerular density (globally sclerotic and non sclerotic) were estimated using the Weibel and Gomez stereologic methods. All tubules were counted in 1 cm2 of cortex to determine a mean profile tubular area. Nephron hypertrophy was identified by larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density. Nephro sclerosis was identified by higher globally sclerotic glomerular density. Results The mean (6SD) age was 44612 years, 24-hour urine albumin excretion was 567mg, measured GFR was 103617 ml/min per 1.73 m2, uric acid was 5.261.4 mg/dl, and body mass index was 2865 kg/m2. Of the study participants, 43% were men, 11% had hypertension, and 52% had a family history of ESRD. Larger glomerular volume, larger profile tubular area, and lower non sclerotic glomerular density were correlated. Male sex, higher 24-hour urine albumin excretion, family history of ESRD, and higher body mass index were independently associated with each of these measures of nephron hypertrophy. Higher uric acid, higher GFR, and older age were also independently associated with some of these measures of nephron hypertrophy. Hypertension was not independently associated with measures of nephron hypertrophy. However, hypertension and older age were independently associated with higher globally sclerotic glomerular density. Conclusions Nephron hypertrophy and nephron sclerosis are structural characteristics in normal adults that relate differently to clinical characteristics and may reflect kidney function and risk factors via separate but inter-related pathways.

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