Renal Pathology in Patients with Reflux Nephropathy

Matsuoka, Hiroaki; Oshima, Kazuhiro; Sakamoto, Kimitaka; Taguchi, Takashi; Takebayashi, Shigeo

doi:10.1159/000475367

Cited by 34 publications

(9 citation statements)

References 14 publications

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“…[10,16] For the treatment of RN, early intervention is therefore necessary to minimize the decrease in nephrons.…”

Section: Discussionmentioning

confidence: 99%

“…This procedure, including the procedures to obtain specimens, processing and staining methods, and the measurement of the glomerular size, was performed according to the previously reported method. [10] The glomerular size was expressed by a mean dimension of 20% of the larger glomeruli cut at the level of vascular pole in the biopsy specimen.…”

Section: Glomerular Sizementioning

confidence: 99%

“…We used the results of our previous study for the age-adjusted normal values of the glomerular size determined by pediatric autopsy cases without renal disease and adult nephrectomy cases with T1 RCC [10,12] :…”

Section: Glomerular Sizementioning

confidence: 99%

“…We previously reported that +2SD was the turning point for progressive reflux nephropathy. [10] Therefore, the cut-off points of +2SD and +4SD were selected. We defined −2SD to +2SD as a normal glomerular size; +2SD to +4SD as an enlarged glomerular size; and >+4 SD as an extremely enlarged glomerular size (see Table 1).…”

Section: Patient Classification According To the Glomerular Sizementioning

confidence: 99%

“…[9] We previously reported that, based on renal biopsy findings, a +2 SD of glomerular size was an important turning point of irreversible deterioration in reflux nephropathy. [10] The most common procedure we use to treat vesicoureteral reflux is anti-reflux surgery. However, a retrospective evaluation showed that most cases of progressive RN showed evidence of multiple renal scars at the time of anti-reflux surgery.…”

Section: Introductionmentioning

confidence: 99%

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Significance of the Renal Functional Reserve in Reflux Nephropathy: An Evaluation According to the Degree of Glomerular Damage

et al. 2007

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Objective. In the treatment of progressive reflux nephropathy (RN), the therapeutic benefit and prognosis of the renal function in RN patients appears to be influenced by the degree of renal functional reserve. We designed this study to determine the presence and characteristics of the renal functional reserve in RN patients. Materials and Methods. In the 35 RN patients with renal scars (19 males; mean age 16.1 years), an exogenous renal clearance test was performed to measure the glomerular filtration rate (GFR) and the effective renal plasma flow (ERPF). In the second half of this test, the renal functional reserve was estimated by measuring the GFR and ERPF during low-dose dopamine infusion. These measurements were then compared with the glomerular size, which had been previously determined by a renal biopsy. Results. Among the patients with a normal glomerular size (−2SD to +2SD), the GFR markedly increased after low-dose dopamine infusion (from 112.15 ± 52.51 to 182.07 ± 69.95mL/min, p < 0.0001), whereas an increase in ERPF was not significant. Among the patients with an enlarged glomerular size (+2SD to +4SD), the GFR and ERPF increased significantly over the baseline values (from 54.60 ± 32.90 to 114.00 ± 65.48 mL/min, p = 0.0076; from 281.01 ± 152.54 to 622.43 ± 392.73 mL/min, p = 0.0155, respectively). Among the patients with an extremely enlarged glomerular size (>+4SD), both the GFR and ERPF remained almost completely unchanged. Conclusion. The renal functional reserve was present even among progressive RN patients with a glomerular size ranging between +2SD and +4SD.

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“…[10,16] For the treatment of RN, early intervention is therefore necessary to minimize the decrease in nephrons.…”

Section: Discussionmentioning

confidence: 99%

Section: Glomerular Sizementioning

confidence: 99%

Section: Glomerular Sizementioning

confidence: 99%

Section: Patient Classification According To the Glomerular Sizementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%