TY - JOUR
T1 - Single-nephron glomerular filtration rate in healthy adults
AU - Denic, Aleksandar
AU - Mathew, Jerry
AU - Lerman, Lilach O.
AU - Lieske, John C.
AU - Larson, Joseph J.
AU - Alexander, Mariam P.
AU - Poggio, Emilio
AU - Glassock, Richard J.
AU - Rule, Andrew D.
N1 - Publisher Copyright:
© 2017 Massachusetts Medical Society.
PY - 2017/6/15
Y1 - 2017/6/15
N2 - BACKGROUND The glomerular filtration rate (GFR) assesses the function of all nephrons, and the single-nephron GFR assesses the function of individual nephrons. How the singlenephron GFR relates to demographic and clinical characteristics and kidney-biopsy findings in humans is unknown. METHODS We identified 1388 living kidney donors at the Mayo Clinic and the Cleveland Clinic who underwent a computed tomographic (CT) scan of the kidney with the use of contrast material and an iothalamate-based measurement of the GFR during donor evaluation and who underwent a kidney biopsy at donation. The mean single-nephron GFR was calculated as the GFR divided by the number of nephrons (calculated as the cortical volume of both kidneys as assessed on CT times the biopsy-determined glomerular density). Demographic and clinical characteristics and biopsy findings were correlated with the single-nephron GFR. RESULTS A total of 58% of the donors were women, and the mean (}SD) age of the donors was 44}12 years. The mean GFR was 115}24 ml per minute, the mean number of nephrons was 860,000}370,000 per kidney, and the mean single-nephron GFR was 80}40 nl per minute. The single-nephron GFR did not vary significantly according to age (among donors <70 years of age), sex, or height (among donors ≤190 cm tall). A higher single-nephron GFR was independently associated with larger nephrons on biopsy and more glomerulosclerosis and arteriosclerosis than would be expected for age. A higher single-nephron GFR was associated with a height of more than 190 cm, obesity, and a family history of end-stage renal disease. CONCLUSIONS Among healthy adult kidney donors, the single-nephron GFR was fairly constant with regard to age, sex, and height (if ≤190 cm). A higher single-nephron GFR was associated with certain risk factors for chronic kidney disease and certain kidneybiopsy findings. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases).
AB - BACKGROUND The glomerular filtration rate (GFR) assesses the function of all nephrons, and the single-nephron GFR assesses the function of individual nephrons. How the singlenephron GFR relates to demographic and clinical characteristics and kidney-biopsy findings in humans is unknown. METHODS We identified 1388 living kidney donors at the Mayo Clinic and the Cleveland Clinic who underwent a computed tomographic (CT) scan of the kidney with the use of contrast material and an iothalamate-based measurement of the GFR during donor evaluation and who underwent a kidney biopsy at donation. The mean single-nephron GFR was calculated as the GFR divided by the number of nephrons (calculated as the cortical volume of both kidneys as assessed on CT times the biopsy-determined glomerular density). Demographic and clinical characteristics and biopsy findings were correlated with the single-nephron GFR. RESULTS A total of 58% of the donors were women, and the mean (}SD) age of the donors was 44}12 years. The mean GFR was 115}24 ml per minute, the mean number of nephrons was 860,000}370,000 per kidney, and the mean single-nephron GFR was 80}40 nl per minute. The single-nephron GFR did not vary significantly according to age (among donors <70 years of age), sex, or height (among donors ≤190 cm tall). A higher single-nephron GFR was independently associated with larger nephrons on biopsy and more glomerulosclerosis and arteriosclerosis than would be expected for age. A higher single-nephron GFR was associated with a height of more than 190 cm, obesity, and a family history of end-stage renal disease. CONCLUSIONS Among healthy adult kidney donors, the single-nephron GFR was fairly constant with regard to age, sex, and height (if ≤190 cm). A higher single-nephron GFR was associated with certain risk factors for chronic kidney disease and certain kidneybiopsy findings. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases).
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U2 - 10.1056/NEJMoa1614329
DO - 10.1056/NEJMoa1614329
M3 - Article
C2 - 28614683
AN - SCOPUS:85020544173
SN - 0028-4793
VL - 376
SP - 2349
EP - 2357
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 24
ER -