Glomerular Density and Volume in Renal Biopsy Specimens of Children with Proteinuria Relative to Preterm Birth and Gestational Age

Koike, Kentaro; Ikezumi, Yohei; Tsuboi, Nobuyuki; Kanzaki, Go; Haruhara, Kotaro; Okabayashi, Yusuke; Sasaki, Takaya; Ogura, Makoto; Saitoh, Akihiko; Yokoo, Takashi

doi:10.2215/cjn.05650516

Cited by 53 publications

(31 citation statements)

References 26 publications

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“…It is widely known that the neonatal glomerulus is immature and that the GFR at birth is one-fourth to one-fifth that of an adult. Furthermore, the nephron number in an adult has been estimated to be one million per kidney; however, recent studies have shown that the nephron number in a Japanese adult is about 0.7 million per kidney [25] and that the glomerular density in a low-birth-weight infant is significantly low [26]. These reports suggest that there may be racial and individual differences in both the nephron number and their development.…”

Section: Discussionmentioning

confidence: 97%

Serum uromodulin is a novel predictive marker of renal function in the Japanese population

Usui

Ogawa

Takahashi³

et al. 2020

Preprint

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Background Uromodulin, also known as Tamm-Horsfall protein, is the most abundant protein in urine. It has recently been reported that uromodulin exists in a small amount in blood and that its concentration correlates with the estimated glomerular filtration rate (eGFR). However, its clinical significance has not been clarified and there are no relevant data for the Japanese population. Method First, we generated anti-human uromodulin mouse monoclonal antibodies and established a specific enzyme-linked immunosorbent assay for uromodulin. We then performed an observational clinical study to determine if there was a correlation between serum uromodulin concentration and estimates of kidney function and whether the serum uromodulin value could be a biomarker in clinical nephrology. The clinical study included 308 patients with and without chronic kidney disease and healthy volunteers. Serum concentrations of creatinine, cystatin C, and uromodulin were measured and correlations were sought between the eGFR calculated from the creatinine and cystatin C levels and the serum uromodulin concentration. Results There was a good correlation between the serum uromodulin concentration and the eGFR value calculated from the creatinine (r=0.76) and cystatin C (r=0.79) levels. The mean serum uromodulin level in the group with an eGFR >90 mL/min/1.73 m 2 calculated using cystatin C was significantly higher than that in the group with an eGFR of 80–89 mL/min/1.73 m 2 . Conclusions The serum uromodulin measurement could be a useful biomarker for identification of patients with early deterioration of kidney function.

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Section: Discussionmentioning

confidence: 97%

Serum uromodulin is a novel predictive marker of renal function in the Japanese population

Usui

Ogawa

Takahashi³

et al. 2020

Preprint

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“…This can be explained by the fact that low GD and glomerulosclerosis could be separate processes, even though glomerular sclerosis plays an important part in leading to low glomerular density. 13 Lower GD can also be caused by low birth weight, [14][15] hypertensive nephrosclerosis, 16 higher body surface, and older age.…”

Section: Discussionmentioning

confidence: 99%

肾小球皮质密度对随访5年的IgA肾病不良预后的预测

Chen

Cai

et al. 2017

cmsj

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Objective To investigate whether glomerular density (GD) could be an independent prognostic factor for patients of IgA nephropathy with estimated glomerular filtration rate (eGFR) of 30 to 60 ml/min per 1.73 m 2 , or for patients with time-average proteinuria < 0.5 g/d.Methods A total of 173 patients with biopsy-confirmed IgA nephropathy diagnosed from January 2000 to December 2010 were included. All of these patients were followed up for more than 5 years. The endpoint was a > 30% of decline in eGFR from baseline after 5-year follow-up. The optimal cut-off value of GD was calculated by ROC curve. Kaplan-Meier method and Cox regression analysis was used for survival analysis.Results A 30% of decline in eGFR occurred in 14.5% of all patients. The optimal diagnostic cut-off value of GD was 1.99/mm 2 (AUC = 0.90, sensitivity = 84.0%, specificity = 81.8%) determined by ROC curve. The low GD group (GD < 1.99 per mm 2 ) experienced a significant increase in renal endpoint for patients with eGFR of 30 to 60 ml/min per 1.73 m 2 (six patients in lower GD group, while one patient in the other group). For patients with time-average proteinuria < 0.5 g/d, the lower GD group showed a higher eGFR decline from baseline (4.5±16.7 ml/min per 1.73 m 2 vs. -8.1±21.4 ml/min per 1.73 m 2 , P = 0.038); two patients in this group reached the endpoint, while no patients in the higher GD group did.Conclusion GD could be an independent prognostic factor for patients of IgA nephropathy with eGFR at 30 to 60 ml/min per 1.73 m 2 of body surface, particularly for those with time-averaged amount of urine protein less than 0.5 g per day.Chin Med Sci J 2017; 32(3):145-151:

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“…Es gibt keine pränatale kausale Therapie bei zystischen Nierenerkrankungen und keine spezifische Möglichkeit, die pränatale Nierenentwicklung positiv zu beeinflussen. Allerdings führt eine Geburt mit niedrigem Gewicht oder Gestationsalter zu einer reduzierten Nephronenmasse [149] und wirkt sich somit negativ auf das langfristige Risiko einer chronischen Niereninsuffizienz aus [150]. Dies gilt auch für die Progression der ADPKD [151].…”

Section: Pränatale Therapieunclassified

Nierenzysten und zystische Nierenerkrankungen bei Kindern (AWMF S2k-Leitlinie)

et al. 2020

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ZusammenfassungDie Leitlinie wurde im Konsens aller relevanten deutschen Fachgesellschaften zusammen mit Patientenvertretern erstellt. Standard der prä- und postnatalen Bildgebung von Nierenzysten ist die Sonografie, die auch im Abdomen und inneren Genitale extrarenale Manifestationen ausschließen soll. Die MRT hat einzelne Indikationen. Bei Verdacht auf zystische Nierenerkrankungen ist eine kindernephrologische Vorstellung indiziert. Die pränatale Betreuung muss auf sehr unterschiedliche Schweregrade zugeschnitten werden. Bei renalem Oligohydramnion wird eine Entbindung in einem Perinatalzentrum der höchsten Stufe empfohlen. Neugeborenen sollte eine Nierenersatztherapie nicht allein aufgrund des Alters vorenthalten werden. Bei unilateraler multizystischer Nierendysplasie ist keine funktionelle Bildgebung oder Nephrektomie notwendig, aber (wie auch bei uni- oder bilateraler Nierenhypo-/dysplasie mit Zysten) eine langfristige nephrologische Überwachung. Bei der ARPKD (autosomal rezessive polyzystische Nierenerkrankung), Nephronophthise, Bardet-Biedl-Syndrom und HNF1B-Mutationen müssen extrarenale Manifestationen beachtet werden; eine genetische Testung ist hier sinnvoll. Kinder mit tuberöser Sklerose, Tumorprädispositionen (z. B. von Hippel Lindau Syndrom) oder hohem Risiko für erworbene Nierenzysten sollten regelmäßige Nierensonografien erhalten. Auch asymptomatische Kinder von Eltern mit ADPKD (aut. dominanter polyzystischer Nierenerkrankung) sollten regelmäßig auf Hypertonie und Proteinurie untersucht werden. Eine präsymptomatische sonografische oder genetische Diagnostik dieser Minderjährigen sollte nur nach ausführlicher Aufklärung erwogen werden. Einfache (isolierte) Zysten sind bei Kindern sehr selten und eine ADPKD eines Elternteils sollte ausgeschlossen sein. Komplexe Nierenzysten bedürfen weiterer Abklärung.

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Glomerular Density and Volume in Renal Biopsy Specimens of Children with Proteinuria Relative to Preterm Birth and Gestational Age

Abstract: A low GD together with marked glomerular enlargement characterizes renal biopsy samples of children born with a LBW at an early stage of gestation.

Cited by 53 publications

References 26 publications

Serum uromodulin is a novel predictive marker of renal function in the Japanese population

Serum uromodulin is a novel predictive marker of renal function in the Japanese population

肾小球皮质密度对随访5年的IgA肾病不良预后的预测

Nierenzysten und zystische Nierenerkrankungen bei Kindern (AWMF S2k-Leitlinie)

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