A stereological study of glomerular number and volume: Preliminary findings in a multiracial study of kidneys at autopsy

Abstract

These extraordinary ranges of glomerular number and size among ostensibly "normal" people, and their inverse relationship, probably have important implications for susceptibility to renal insufficiency. People with low glomerular (nephron) numbers are likely to be particularly predisposed, with the process marked by compensatory hypertrophy of residual nephrons, which, in turn, accelerates their obsolescence. Much, however, remains to be done, including evaluation of history, clinical features, accompanying pathology, detailed renal morphology, and further pursuit of potentially defining characteristics in high risk groups.

Nephron Endowment and Filtration Surface Area in the Kidney after Growth Restriction of Fetal Sheep

“…In humans, it has been suggested that sudden infant death syndrome is associated with lower birth weights (22) and lower nephron numbers (23), although later studies do not confirm this (24). The range of nephrons found in our control fetuses was large, as in the human population (25). Given the strong link between birth weight and nephron number in many studies, the wide range in the control animals is probably due to the spectrum in birth weights observed in a normal population (26).…”

Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

“…There is substantial variation in nephron endowment across the population (22). A low nephron endowment is associated with larger glomeruli, low birth weight (23,24), and increased risk of kidney failure (25,26).…”

Pathophysiology of the aging kidney and therapeutic interventions

“…[48][49][50] The reason for the unaltered kidney volume in the elderly despite age-related glomerulosclerosis 51 may be the compensatory hypertrophy of unaffected nephrons in response to the significant nephron loss caused by glomerulosclerosis and tubular atrophy. 4 Studies have reported both increased volume in the functional glomeruli and decreased glomerular density in aging kidneys. [52][53][54][55] The pathological characteristics of aging kidneys include glomerular sclerosis, tubular atrophy and tubulointerstitial fibrosis.…”

“…2 Renal mass decreases between the ages of 30 and 80 years, with the steepest decline observed after age 50. 3,4 Fat and fibrosis scarring may replace some of the remaining functional parenchymal tissue. [4][5][6] This scarring and loss of kidney parenchymal tissue occurs primarily in the renal cortex; 6 therefore, scarring affects the nephrons that are important for maximal urine concentration.…”

“…3,4 Fat and fibrosis scarring may replace some of the remaining functional parenchymal tissue. [4][5][6] This scarring and loss of kidney parenchymal tissue occurs primarily in the renal cortex; 6 therefore, scarring affects the nephrons that are important for maximal urine concentration. Even in normal aging kidneys, 30% of the glomeruli are destroyed and display diffuse glomerular sclerosis by age 75, 7 and the remaining glomeruli exhibit impaired filtering ability.…”