Compensatory renal growth after unilateral or subtotal nephrectomy in the ovine fetus

Abstract

Background:Clinical and experimental studies show that unilateral (1/2Nx) and subtotal nephrectomy (5/6Nx) in adults result in compensatory renal growth without formation of new nephrons. During nephrogenesis, the response to renal mass reduction has not been fully investigated. Methods: Ovine fetuses underwent 1/2Nx, 5/6Nx, or sham surgery (sham) at 70 d of gestation (term: 150 d), when nephrogenesis is active. At 134 d, renal function was determined, fetuses were killed, and kidneys were further analyzed at the cellular and molecular levels. Additional fetuses subjected to 5/6Nx were killed at 80 and 90 d of gestation to investigate the kinetics of the renal compensatory process. results: At 134 d, in 1/2Nx, a significant increase in kidney weight and estimated glomerular number was observed. In 5/6Nx, the early and marked catch-up in kidney weight and estimated glomerular number was associated with a striking butterfly-like remodeling of the kidney that developed within the first 10 d following nephrectomy. In all groups, in utero glomerular filtration rates were similar. conclusion: Compensatory renal growth was observed after parenchymal reduction in both models; however, the resulting compensatory growth was strikingly different. After 5/6Nx, the remnant kidney displayed a butterfly-like remodeling, and glomerular number was restored.

Early Renal Ultrasound in Patients with Congenital Solitary Kidney Can Guide Follow-Up Strategy Reducing Costs While Keeping Long-Term Prognostic Information

“…In fact, a RL > 2SDS in the early post-natal period could reflect renal hyperplasia characterized by increased nephron endowment [5][6][7] and subsequent reduced risk of hyperfiltration and kidney injury (KI) [8].…”

Early Renal Ultrasound in Congenital Solitary Kidney May Help to Select Patients at Lower Risk of Associated Vesicoureteral Reflux

“…We hypothesized that a CSFK with VUR will present scarce probability to have a renal length (RL) >2 standard deviation score (SDS) in the first months of life due to VUR-associated renal dysplasia which could affect prenatal nephron formation and that an RL >2 SDS in the early postnatal period could identify CSFK patients with lower probability of presenting VUR. The criterion of an RL >2 SDS was a priori chosen on the basis of evidence that CSFK patients with early-in-life RL >2 SDS present lower risk of later decline of renal function because of prenatal compensatory nephron formation [6], as shown in animals [7]. Moreover, most of the CSFK patients develop renal compensatory hypertrophy within the first year of life [8], which is characterized by an increased size, but not number, of nephrons [6, 9].…”

Ultrastructural changes and nestin expression accompanying compensatory renal growth after unilateral nephrectomy in adult rats

“…[50][51][52][53][54] The space within the capillaries is increased, while the glomerular area is decreased; this might be due to the possible noncorrelation between the glomerular area and the glomerular cell proliferation. 55 The low expression level of nestin is normal in adult cells, as its expression is downregulated when the cells are in nonstressed conditions, 54,56 while its increased expression indicates cellular stress, which results in cellular proliferation and angiogenesis. 57 Accordingly, decreased nestin expression indicates improvement of cellular stress.…”