Histological features of glomerular immaturity in infants and small children with normal or altered tubular function

Thóny, H. C.; Luethy, C. M.; Zimmermann, A.; Laux-End, R; Oetliker, O; Bianchetti, Mario G.

doi:10.1007/bf02191509

Cited by 18 publications

(15 citation statements)

References 9 publications

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“…Such structure and disposition of podocytes are characteristics of their immaturity. 17 Thöny et al 17 laid out the criteria that subdivide the postnatal glomerular maturation into 3 stages. Stage 1 is characterized by fully formed glomeruli with at least half of the circumference of the tuft lined with cuboidal podocytes.…”

Section: Discussionmentioning

confidence: 99%

En Bloc Cadaver Kidney Transplantation From a 9-Month-Old Donor to an Adult Recipient: Maturation of Glomerular Size and Podocyte in the Recipient

Hirukawa

Suzuki

Niimura

et al. 2017

Transplantation Direct

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BackgroundFavorable outcomes of en bloc pediatric donor kidney transplantation to adult recipients are attributed primarily to grafting of twice the nephron mass of a single kidney.MethodsThe kidneys of a 9-month-old male infant were transplanted en bloc in a 56-year-old man. Biopsies were performed 1 hour postreperfusion, 6 months and 3.5 years posttransplant.ResultsWarm and cold ischemia times were 21 and 426 minutes, respectively. The recipient was released from hemodialysis 10 days posttransplant and discharged 91 days posttransplant when serum creatinine was 0.9 mg/dL. At 4 years and 9 months posttransplant, serum creatinine was 1.0 mg/dL, and estimated glomerular filtration rate was 58.0 mL/min per 1.73 m2. The grafts increased in size until they reached adult size by 3 months posttransplant. The glomerular area and volume, respectively, increased from 5.9 × 103 μm2 and 0.34 × 106 μm3 at 1 hour postreperfusion to 14.9 × 103 μm2 and 1.27 × 106 μm3 at 3.5 years posttransplant, both of which were less than half of adult size. At 1 hour postreperfusion, podocytes were structurally immature. At 6 months posttransplant, podocyte immaturity was still evident. At 3.5 years posttransplant, podocytes were mature.ConclusionsThese findings suggest that podocytes and glomerular size of pediatric donor kidneys can continue to mature in adult recipients at rates appropriate for donor age when transplanted en bloc. The maturational levels of podocytes and glomeruli may also be a factor involved in favorable outcomes of en bloc pediatric donor kidney transplantation.

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Section: Discussionmentioning

confidence: 99%

En Bloc Cadaver Kidney Transplantation From a 9-Month-Old Donor to an Adult Recipient: Maturation of Glomerular Size and Podocyte in the Recipient

Hirukawa

Suzuki

Niimura

et al. 2017

Transplantation Direct

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“…Stages of glomerular maturity in the developing human kidney. The following criteria for the assessment of glomerular maturation are based on Naruse et al 47 and Thony et al 48 …”

Section: Discussionmentioning

confidence: 99%

“…The criterion for grading each stage of glomerular maturity is detailed in Figure 7. Immature glomeruli in the early stages of development (stages V, C, and S) were graded according to the criteria of Naruse et al 47 More mature glomeruli (stages I, II, and III) were graded according to the criteria of Thony et al 48 The percentage of abnormal glomeruli at each stage of development per kidney was determined. Glomeruli were classified as abnormal if they exhibited a grossly enlarged Bowman's space and a shrunken glomerular tuft.…”

Section: Glomerular Maturity and Morphologymentioning

confidence: 99%

Accelerated Maturation and Abnormal Morphology in the Preterm Neonatal Kidney

Sutherland

Gubhaju²,

Moore

et al. 2011

Journal of the American Society of Nephrology

287

253

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Nephrogenesis is ongoing at the time of birth for the majority of preterm infants, but whether postnatal renal development follows a similar trajectory to normal in utero growth is unknown. Here, we examined tissue collected at autopsy from 28 kidneys from preterm neonates, whose postnatal survival ranged from 2 to 68 days, including 6 that had restricted intrauterine growth. In addition, we examined kidneys from 32 still-born gestational controls. We assessed the width of the nephrogenic zone, number of glomerular generations, cross-sectional area of the renal corpuscle, and glomerular maturity and morphology. Renal maturation accelerated after preterm birth, with an increased number of glomerular generations and a decreased width of the nephrogenic zone in the kidneys of preterm neonates. Of particular concern, compared with gestational controls, preterm kidneys had a greater percentage of morphologically abnormal glomeruli and a significantly larger cross-sectional area of the renal corpuscle, suggestive of renal hyperfiltration. These observations suggest that the preterm kidney may have fewer functional nephrons, thereby increasing vulnerability to impaired renal function in both the early postnatal period and later in life.

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“…Three stages of glomerular maturation could be distinguished based on the literature (Fig. 1C) [23]. Importantly, fully mature glomeruli contained different cell types present in adult glomeruli, including CD31 + endothelial cells, and podoplanin + podocytes (Fig.…”

Section: The Lymph Node Is a Permissive Site For Kidney Organogenesismentioning

confidence: 96%

The Lymph Node as a New Site for Kidney Organogenesis

Francipane

Lagasse

2015

Stem Cells Translational Medicine

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The shortage of organs for kidney transplantation has created the need to develop new strategies to restore renal structure and function. Given our recent finding that the lymph node (LN) can serve as an in vivo factory to generate or sustain complex structures like liver, pancreas, and thymus, we investigated whether it could also support kidney organogenesis from mouse renal embryonic tissue (metanephroi). Here we provide the first evidence that metanephroi acquired a mature phenotype upon injection into LN, and host cells likely contributed to this process. Urine-like fluid-containing cysts were observed in several grafts 12 weeks post-transplantation, indicating metanephroi transplants' ability to excrete products filtered from the blood. Importantly, the kidney graft adapted to a loss of host renal mass, speeding its development. Thus, the LN might provide a unique tool for studying the mechanisms of renal maturation, cell proliferation, and fluid secretion during cyst development. Moreover, we provide evidence that inside the LN, short-term cultured embryonic kidney cells stimulated with the Wnt agonist R-Spondin 2 gave rise to a monomorphic neuron-like cell population expressing the neuronal 200-kDa neurofilament heavy marker. This finding indicates that the LN might be used to validate the differentiation potential of candidate stem cells in regenerative nephrology. STEM CELLS TRANSLATIONAL MEDICINE 2015;4:295-307

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Histological features of glomerular immaturity in infants and small children with normal or altered tubular function

Cited by 18 publications

References 9 publications

En Bloc Cadaver Kidney Transplantation From a 9-Month-Old Donor to an Adult Recipient: Maturation of Glomerular Size and Podocyte in the Recipient

En Bloc Cadaver Kidney Transplantation From a 9-Month-Old Donor to an Adult Recipient: Maturation of Glomerular Size and Podocyte in the Recipient

Accelerated Maturation and Abnormal Morphology in the Preterm Neonatal Kidney

The Lymph Node as a New Site for Kidney Organogenesis

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