Literature DB >> 21984554

Estimating individual glomerular volume in the human kidney: clinical perspectives.

Victor G Puelles1, Monika A Zimanyi, Terence Samuel, Michael D Hughson, Rebecca N Douglas-Denton, John F Bertram, James A Armitage.   

Abstract

BACKGROUND: Measurement of individual glomerular volumes (IGV) has allowed the identification of drivers of glomerular hypertrophy in subjects without overt renal pathology. This study aims to highlight the relevance of IGV measurements with possible clinical implications and determine how many profiles must be measured in order to achieve stable size distribution estimates.
METHODS: We re-analysed 2250 IGV estimates obtained using the disector/Cavalieri method in 41 African and 34 Caucasian Americans. Pooled IGV analysis of mean and variance was conducted. Monte-Carlo (Jackknife) simulations determined the effect of the number of sampled glomeruli on mean IGV. Lin's concordance coefficient (R(C)), coefficient of variation (CV) and coefficient of error (CE) measured reliability.
RESULTS: IGV mean and variance increased with overweight and hypertensive status. Superficial glomeruli were significantly smaller than juxtamedullary glomeruli in all subjects (P < 0.01), by race (P < 0.05) and in obese individuals (P < 0.01). Subjects with multiple chronic kidney disease (CKD) comorbidities showed significant increases in IGV mean and variability. Overall, mean IGV was particularly reliable with nine or more sampled glomeruli (R(C) > 0.95, <5% difference in CV and CE). These observations were not affected by a reduced sample size and did not disrupt the inverse linear correlation between mean IGV and estimated total glomerular number.
CONCLUSIONS: Multiple comorbidities for CKD are associated with increased IGV mean and variance within subjects, including overweight, obesity and hypertension. Zonal selection and the number of sampled glomeruli do not represent drawbacks for future longitudinal biopsy-based studies of glomerular size and distribution.

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Year:  2011        PMID: 21984554      PMCID: PMC3339444          DOI: 10.1093/ndt/gfr539

Source DB:  PubMed          Journal:  Nephrol Dial Transplant        ISSN: 0931-0509            Impact factor:   5.992


  51 in total

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Review 4.  Heterogeneity of nephron anatomy.

Authors:  L Bankir; N Bouby; M M Trinh-Trang-Tan
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10.  Obesity-related glomerulopathy in China: a case series of 90 patients.

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  11 in total

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Authors:  Victor G Puelles; Rebecca N Douglas-Denton; Monika A Zimanyi; James A Armitage; Michael D Hughson; Peter G Kerr; John F Bertram
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5.  Detection and Clinical Patterns of Nephron Hypertrophy and Nephrosclerosis Among Apparently Healthy Adults.

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7.  MRI-based glomerular morphology and pathology in whole human kidneys.

Authors:  Scott C Beeman; Luise A Cullen-McEwen; Victor G Puelles; Min Zhang; Teresa Wu; Edwin J Baldelomar; John Dowling; Jennifer R Charlton; Michael S Forbes; Amanda Ng; Qi-zhu Wu; James A Armitage; Gary F Egan; John F Bertram; Kevin M Bennett
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8.  Quantitative morphometrics reveals glomerular changes in patients with infrequent segmentally sclerosed glomeruli.

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Review 9.  The Renal Pathology of Obesity.

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10.  Hypertension, glomerular hypertrophy and nephrosclerosis: the effect of race.

Authors:  Michael D Hughson; Victor G Puelles; Wendy E Hoy; Rebecca N Douglas-Denton; Susan A Mott; John F Bertram
Journal:  Nephrol Dial Transplant       Date:  2013-12-09       Impact factor: 5.992

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