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Puelles VG, Cullen-McEwen LA, Taylor GE, Li J, Hughson MD, Kerr PG, Hoy WE, Bertram JF. Human podocyte depletion in association with older age and hypertension. Am J Physiol Renal Physiol 2016; 310:F656-F668. [PMID: 26792066 DOI: 10.1152/ajprenal.00497.2015] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/12/2016] [Indexed: 12/27/2022] Open
Abstract
Podocyte depletion plays a major role in the development and progression of glomerulosclerosis. Many kidney diseases are more common in older age and often coexist with hypertension. We hypothesized that podocyte depletion develops in association with older age and is exacerbated by hypertension. Kidneys from 19 adult Caucasian American males without overt renal disease were collected at autopsy in Mississippi. Demographic data were obtained from medical and autopsy records. Subjects were categorized by age and hypertension as potential independent and additive contributors to podocyte depletion. Design-based stereology was used to estimate individual glomerular volume and total podocyte number per glomerulus, which allowed the calculation of podocyte density (number per volume). Podocyte depletion was defined as a reduction in podocyte number (absolute depletion) or podocyte density (relative depletion). The cortical location of glomeruli (outer or inner cortex) and presence of parietal podocytes were also recorded. Older age was an independent contributor to both absolute and relative podocyte depletion, featuring glomerular hypertrophy, podocyte loss, and thus reduced podocyte density. Hypertension was an independent contributor to relative podocyte depletion by exacerbating glomerular hypertrophy, mostly in glomeruli from the inner cortex. However, hypertension was not associated with podocyte loss. Absolute and relative podocyte depletion were exacerbated by the combination of older age and hypertension. The proportion of glomeruli with parietal podocytes increased with age but not with hypertension alone. These findings demonstrate that older age and hypertension are independent and additive contributors to podocyte depletion in white American men without kidney disease.
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Affiliation(s)
- Victor G Puelles
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia;
| | - Luise A Cullen-McEwen
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
| | - Georgina E Taylor
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
| | - Jinhua Li
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
| | - Michael D Hughson
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Peter G Kerr
- Department of Nephrology, Monash Medical Centre, and Department of Medicine, Monash University, Melbourne, Victoria, Australia; and
| | - Wendy E Hoy
- Centre for Chronic Disease, The University of Queensland, Brisbane, Queensland, Australia
| | - John F Bertram
- Cardiovascular Program, Monash Biomedicine Discovery Institute and Department of Anatomy and Developmental Biology, Monash University, Melbourne, Victoria, Australia
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Finne K, Marti HP, Leh S, Skogstrand T, Vethe H, Tenstad O, Berven FS, Scherer A, Vikse BE. Proteomic Analysis of Minimally Damaged Renal Tubular Tissue from Two-Kidney-One-Clip Hypertensive Rats Demonstrates Extensive Changes Compared to Tissue from Controls. Nephron Clin Pract 2016; 132:70-80. [PMID: 26745798 DOI: 10.1159/000442825] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/25/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tubular atrophy and interstitial fibrosis mark the final stage in most forms of progressive kidney diseases. Little is known regarding changes in the tubular proteome. In this study, we investigated changes in the tubular proteome of normal or minimally damaged tubular tissue in the non-clipped kidney from rats with two-kidney one-clip (2K1C) hypertension. METHODS Formalin-fixed paraffin-embedded kidney sections from four 2K1C rats with hypertensive kidney damage and 6 sham rats were used. Tubulointerstitial tissue without discernable interstitial expansion or pronounced tubular alterations was microdissected and this was assumed to represent an early stage of chronic tubular damage in 2K1C. Samples were analyzed by mass spectrometry and relative protein abundances were compared between 2K1C and sham. RESULTS A total of 1,160 proteins were identified with at least 2 unique peptides, allowing for relative quantitation between samples. Among these, 151 proteins were more abundant, and 192 proteins were less abundant in 2K1C compared with sham. Transgelin, vimentin and creatine kinase B-type were among the proteins that were most increased in 2K1C. Ingenuity Pathway Analysis showed increased abundance of proteins related to Rho signaling and protein turnover (eIF2 signaling and protein ubiquitination), and decreased abundance of proteins related to fatty acid β-oxidation. CONCLUSION Tubular tissue from normal or minimally damaged hypertensive kidney damage demonstrate extensive proteomic changes with upregulation of pathways associated with progressive kidney damage, such as Rho signaling and protein turnover. Thus, proteomics presents itself to be a promising tool for the discovery of early damage markers from not yet morphologically visible tubular damage.
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Hoy WE, Hughson MD, Kopp JB, Mott SA, Bertram JF, Winkler CA. APOL1 Risk Alleles Are Associated with Exaggerated Age-Related Changes in Glomerular Number and Volume in African-American Adults: An Autopsy Study. J Am Soc Nephrol 2015; 26:3179-89. [PMID: 26038529 PMCID: PMC4657832 DOI: 10.1681/asn.2014080768] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 03/09/2015] [Indexed: 01/13/2023] Open
Abstract
APOL1 genetic variants contribute to kidney disease in African Americans. We assessed correlations between APOL1 profiles and renal histological features in subjects without renal disease. Glomerular number (N glom) and mean glomerular volume (V glom) were measured by the dissector/fractionator method in kidneys of African-American and non-African-American adults without renal disease, undergoing autopsies in Jackson, Mississippi. APOL1 risk alleles were genotyped and the kidney findings were evaluated in the context of those profiles. The proportions of African Americans with none, one, and two APOL1 risk alleles were 38%, 43%, and 19%, respectively; 38% of African Americans had G1 allele variants and 31% of African Americans had G2 allele variants. Only APOL1-positive African Americans had significant reductions in N glom and increases in V glom with increasing age. Regression analysis predicted an annual average loss of 8834 (P=0.03, sex adjusted) glomeruli per single kidney over the first 38 years of adult life in African Americans with two risk alleles. Body mass index above the group medians, but below the obesity definition of ≥ 30 kg/m(2), enhanced the expression of age-related changes in N glom in African Americans with either one or two APOL1 risk alleles. These findings indicate that APOL1 risk alleles are associated with exaggerated age-related nephron loss, probably decaying from a larger pool of smaller glomeruli in early adult life, along with enlargement of the remaining glomeruli. These phenomena might mark mechanisms of accentuated susceptibility to kidney disease in APOL1-positive African Americans.
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Affiliation(s)
- Wendy E Hoy
- Centre for Chronic Disease, The University of Queensland, Brisbane, Queensland, Australia;
| | - Michael D Hughson
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Jeffrey B Kopp
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Disease, National Institutes of Health, Bethesda, Maryland
| | - Susan A Mott
- Centre for Chronic Disease, The University of Queensland, Brisbane, Queensland, Australia
| | - John F Bertram
- Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Monash University, Melbourne, Victoria, Australia; and
| | - Cheryl A Winkler
- Basic Research Laboratory, Center for Cancer Research, National Cancer Institute, Lidos Biomedical Inc., Frederick National Laboratory, Frederick, Maryland
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Kato T, Relator R, Ngouv H, Hirohashi Y, Takaki O, Kakimoto T, Okada K. Segmental HOG: new descriptor for glomerulus detection in kidney microscopy image. BMC Bioinformatics 2015; 16:316. [PMID: 26423821 PMCID: PMC4590714 DOI: 10.1186/s12859-015-0739-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 09/11/2015] [Indexed: 11/13/2022] Open
Abstract
Background The detection of the glomeruli is a key step in the histopathological evaluation of microscopic images of the kidneys. However, the task of automatic detection of the glomeruli poses challenges owing to the differences in their sizes and shapes in renal sections as well as the extensive variations in their intensities due to heterogeneity in immunohistochemistry staining. Although the rectangular histogram of oriented gradients (Rectangular HOG) is a widely recognized powerful descriptor for general object detection, it shows many false positives owing to the aforementioned difficulties in the context of glomeruli detection. Results A new descriptor referred to as Segmental HOG was developed to perform a comprehensive detection of hundreds of glomeruli in images of whole kidney sections. The new descriptor possesses flexible blocks that can be adaptively fitted to input images in order to acquire robustness for the detection of the glomeruli. Moreover, the novel segmentation technique employed herewith generates high-quality segmentation outputs, and the algorithm is assured to converge to an optimal solution. Consequently, experiments using real-world image data revealed that Segmental HOG achieved significant improvements in detection performance compared to Rectangular HOG. Conclusion The proposed descriptor for glomeruli detection presents promising results, and it is expected to be useful in pathological evaluation.
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Affiliation(s)
- Tsuyoshi Kato
- Faculty of Science and Engineering, Gunma University, Kiryu-shi, Gunma, 376-8515, Japan. .,Center for Informational Biology, Ochanomizu University, Bunkyo-ku, Tokyo, 112-8610, Japan.
| | - Raissa Relator
- Faculty of Science and Engineering, Gunma University, Kiryu-shi, Gunma, 376-8515, Japan
| | - Hayliang Ngouv
- Faculty of Science and Engineering, Gunma University, Kiryu-shi, Gunma, 376-8515, Japan
| | - Yoshihiro Hirohashi
- Faculty of Science and Engineering, Gunma University, Kiryu-shi, Gunma, 376-8515, Japan
| | - Osamu Takaki
- Gunma University Hospital, Maebashi-shi, Gunma, 371-8511, Japan
| | - Tetsuhiro Kakimoto
- Research Division, Mitsubishi Tanabe Pharma Corporation, Toda-shi, Saitama, 335-8505, Japan
| | - Kinya Okada
- Research Division, Mitsubishi Tanabe Pharma Corporation, Toda-shi, Saitama, 335-8505, Japan
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Haruhara K, Tsuboi N, Kanzaki G, Koike K, Suyama M, Shimizu A, Miyazaki Y, Kawamura T, Ogura M, Yokoo T. Glomerular Density in Biopsy-Proven Hypertensive Nephrosclerosis. Am J Hypertens 2015; 28:1164-71. [PMID: 25631380 DOI: 10.1093/ajh/hpu267] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/25/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous autopsy studies suggested that a reduced nephron number is associated with increased risk of hypertension and chronic kidney disease. However, the significance of the nephron number estimated from a renal biopsy in patients with hypertensive nephrosclerosis (HNS) has not yet been elucidated. METHODS In this cross-sectional study, we examined the clinicopathological findings of biopsy-proven HNS patients with preserved renal function (estimated glomerular filtration rate ≥ 60 ml/min/1.73 m(2)). The glomerular density (GD; the number of glomeruli per total renal cortical area) in biopsy specimens was evaluated as a surrogate of the nephron number. Renal biopsies from kidney transplant donors were used as healthy controls. RESULTS A total of 58 HNS patients were enrolled. The GD value in the HNS patients was low compared with those in the kidney transplant donors (2.0 vs. 3.2 /mm(2)). These differences remained significant when globally sclerotic glomeruli were included in the calculation of the GD. Of note, the GD in HNS patients with overt proteinuria (≥1 g/day) was significantly lower than that of HNS patients with mild proteinuria (<1g/day; 1.8 vs. 2.2/mm(2), P = 0.014). In contrast, other histopathological parameters, including the severity of global glomerulosclerosis, interstitial fibrosis/tubular atrophy and arterial and arteriole lesions were comparable between the 2 HNS subgroups. In addition, the GD was identified as a factor that was associated with the amount of urinary protein excretion at biopsy, independent of other clinicopathological factors. CONCLUSIONS These results suggest that a low GD is a renal histological characteristic of HNS patients, especially those with overt proteinuria.
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Affiliation(s)
- Kotaro Haruhara
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Nobuo Tsuboi
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan.
| | - Go Kanzaki
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Kentaro Koike
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Masahiro Suyama
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Akihiro Shimizu
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Yoichi Miyazaki
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Tetsuya Kawamura
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Makoto Ogura
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
| | - Takashi Yokoo
- Department of Internal Medicine, Division of Nephrology and Hypertension, The Jikei University School of Medicine, Minato-Ku, Tokyo, Japan
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Kanzaki G, Tsuboi N, Haruhara K, Koike K, Ogura M, Shimizu A, Yokoo T. Factors associated with a vicious cycle involving a low nephron number, hypertension and chronic kidney disease. Hypertens Res 2015; 38:633-41. [PMID: 26084263 DOI: 10.1038/hr.2015.67] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 12/15/2022]
Abstract
It has been reported that there is substantial variation in the nephron number between individuals. Previous studies using autopsy kidneys have demonstrated that a low nephron number, in relation to a low birth weight, may result in hypertension (HTN) and/or chronic kidney disease (CKD). However, recent studies have revealed that the association between a low nephron number and HTN is not a universal finding. This observation indicates that a low nephron number is unlikely to be the sole factor contributing to an elevated blood pressure. In addition to the nephron number, various genetic and congenital factors may contribute to increased susceptibility to HTN and/or CKD in a complex manner. Acquired factors, including aging, obesity and related metabolic abnormalities, and various causes of renal injury, may additionally promote further nephron loss. Such a vicious cycle may induce HTN and/or CKD via the common mechanisms of renal hemodynamic maladaptation.
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Affiliation(s)
- Go Kanzaki
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuo Tsuboi
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kotaro Haruhara
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kentaro Koike
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Makoto Ogura
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Takashi Yokoo
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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Kremers WK, Denic A, Lieske JC, Alexander MP, Kaushik V, Elsherbiny HE, Chakkera HA, Poggio ED, Rule AD. Distinguishing age-related from disease-related glomerulosclerosis on kidney biopsy: the Aging Kidney Anatomy study. Nephrol Dial Transplant 2015; 30:2034-9. [PMID: 25888387 DOI: 10.1093/ndt/gfv072] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 02/24/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Global glomerulosclerosis is characteristic of chronic kidney disease and also occurs with normal aging. Our goal was to determine the upper limit of normal for number of globally sclerotic glomeruli. METHODS Core-needle biopsies of the renal cortex were obtained at the time of living kidney transplantation at three centers between 1998 and 2011. The number of globally sclerotic glomeruli was averaged across two biopsy sections. Quantile regression was used to estimate the 95th percentile for globally sclerotic glomeruli as the upper reference limit. There were 2052 donors (mean age 43 years, 41% male, 10% hypertensive), with a mean (SD) of 16.0 (9.7) glomeruli and 0.47 (0.99) globally sclerotic glomeruli on biopsy; only 2.6% had >5% fibrosis. RESULTS In a multivariable model excluding hypertensive donors, independent predictors of the number of globally sclerotic glomeruli were age, total number of glomeruli and cortex area. A simplified model was used to estimate the 95th percentile for number of globally sclerotic glomeruli by total number of glomeruli and age. For a biopsy section with 17-32 total glomeruli, the 95th percentile ranged from 1 for a 20-year old to 5.5 for a 70-year old donor. Hypertensive donors were more likely to have an abnormal number of globally sclerotic glomeruli (OR = 1.79, P = 0.035). CONCLUSIONS We have derived the 95% reference limit for number of globally sclerotic glomeruli in ostensibly healthy individuals accounting for age and the biopsy characteristics. Numbers of globally sclerotic glomeruli in a kidney biopsy that exceed these thresholds suggest chronic pathological injury in excess of that expected with normal aging.
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Affiliation(s)
- Walter K Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN, USA
| | - Aleksandar Denic
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - John C Lieske
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Mariam P Alexander
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vidhu Kaushik
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Harini A Chakkera
- Division of Nephrology and Hypertension, Mayo Clinic, Scottsdale, AZ, USA
| | - Emilio D Poggio
- Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH, USA
| | - Andrew D Rule
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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Singh RR, Denton KM. Role of the kidney in the fetal programming of adult cardiovascular disease: an update. Curr Opin Pharmacol 2015; 21:53-9. [PMID: 25588322 DOI: 10.1016/j.coph.2014.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 01/13/2023]
Abstract
It is well established that an adverse in utero environment can impinge upon fetal development and place the offspring on a track leading to future cardiovascular disease. Significantly, this may occur in the absence of any outward manifestations at birth. In this brief review, we focus on potential renal mechanisms that lead to adaptations in glomerular and tubular function that initiate hypertension of developmental origin and examine potential therapeutic interventions. This report updates recent data in this field.
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Affiliation(s)
- Reetu R Singh
- Department of Physiology, Monash University, Clayton, Victoria 3800, Australia
| | - Kate M Denton
- Department of Physiology, Monash University, Clayton, Victoria 3800, Australia.
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Puelles VG, Douglas-Denton RN, Cullen-McEwen LA, Li J, Hughson MD, Hoy WE, Kerr PG, Bertram JF. Podocyte Number in Children and Adults: Associations with Glomerular Size and Numbers of Other Glomerular Resident Cells. J Am Soc Nephrol 2015; 26:2277-88. [PMID: 25568174 DOI: 10.1681/asn.2014070641] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/02/2014] [Indexed: 11/03/2022] Open
Abstract
Increases in glomerular size occur with normal body growth and in many pathologic conditions. In this study, we determined associations between glomerular size and numbers of glomerular resident cells, with a particular focus on podocytes. Kidneys from 16 male Caucasian-Americans without overt renal disease, including 4 children (≤3 years old) to define baseline values of early life and 12 adults (≥18 years old), were collected at autopsy in Jackson, Mississippi. We used a combination of immunohistochemistry, confocal microscopy, and design-based stereology to estimate individual glomerular volume (IGV) and numbers of podocytes, nonepithelial cells (NECs; tuft cells other than podocytes), and parietal epithelial cells (PECs). Podocyte density was calculated. Data are reported as medians and interquartile ranges (IQRs). Glomeruli from children were small and contained 452 podocytes (IQR=335-502), 389 NECs (IQR=265-498), and 146 PECs (IQR=111-206). Adult glomeruli contained significantly more cells than glomeruli from children, including 558 podocytes (IQR=431-746; P<0.01), 1383 NECs (IQR=998-2042; P<0.001), and 367 PECs (IQR=309-673; P<0.001). However, large adult glomeruli showed markedly lower podocyte density (183 podocytes per 10(6) µm(3)) than small glomeruli from adults and children (932 podocytes per 10(6) µm(3); P<0.001). In conclusion, large adult glomeruli contained more podocytes than small glomeruli from children and adults, raising questions about the origin of these podocytes. The increased number of podocytes in large glomeruli does not match the increase in glomerular size observed in adults, resulting in relative podocyte depletion. This may render hypertrophic glomeruli susceptible to pathology.
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Affiliation(s)
- Victor G Puelles
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | | | - Luise A Cullen-McEwen
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Jinhua Li
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Michael D Hughson
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Wendy E Hoy
- Centre for Chronic Disease, The University of Queensland, Brisbane, Australia
| | - Peter G Kerr
- Department of Nephrology, Monash Medical Centre, Melbourne, Australia; and Department of Medicine, Monash University, Melbourne, Australia
| | - John F Bertram
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia;
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Ackoundou-N’Guessan KC, N’Zoue S, Lagou AD, Tia MW, Guei CM, Coulibaly AP, Gnionsahe AD. Épidémiologie de l’hypertension artérielle non contrôlée au cours des maladies rénales chroniques chez des patients admis dans une unité de néphrologie d’Afrique noire : une étude rétrospective de 479 patients. Nephrol Ther 2014; 10:518-27. [DOI: 10.1016/j.nephro.2014.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 08/19/2014] [Accepted: 08/25/2014] [Indexed: 10/24/2022]
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Elsherbiny HE, Alexander MP, Kremers WK, Park WD, Poggio ED, Prieto M, Lieske JC, Rule AD. Nephron hypertrophy and glomerulosclerosis and their association with kidney function and risk factors among living kidney donors. Clin J Am Soc Nephrol 2014; 9:1892-902. [PMID: 25318758 DOI: 10.2215/cjn.02560314] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES The relationship of kidney function and CKD risk factors to structural changes in the renal parenchyma of normal adults is unclear. This study assessed whether nephron hypertrophy and nephrosclerosis had similar or different associations with kidney function and risk factors. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS From 1999 to 2009, 1395 living kidney donors had a core needle biopsy of their donated kidney during transplant surgery. The mean nonsclerotic glomerular volume and glomerular density (globally sclerotic and nonsclerotic) were estimated using the Weibel and Gomez stereologic methods. All tubules were counted in 1 cm(2) of cortex to determine a mean profile tubular area. Nephron hypertrophy was identified by larger glomerular volume, larger profile tubular area, and lower nonsclerotic glomerular density. Nephrosclerosis was identified by higher globally sclerotic glomerular density. RESULTS The mean (± SD) age was 44 ± 12 years, 24-hour urine albumin excretion was 5 ± 7 mg, measured GFR was 103 ± 17 ml/min per 1.73 m(2), uric acid was 5.2 ± 1.4 mg/dl, and body mass index was 28 ± 5 kg/m(2). Of the study participants, 43% were men, 11% had hypertension, and 52% had a family history of ESRD. Larger glomerular volume, larger profile tubular area, and lower nonsclerotic glomerular density were correlated. Male sex, higher 24-hour urine albumin excretion, family history of ESRD, and higher body mass index were independently associated with each of these measures of nephron hypertrophy. Higher uric acid, higher GFR, and older age were also independently associated with some of these measures of nephron hypertrophy. Hypertension was not independently associated with measures of nephron hypertrophy. However, hypertension and older age were independently associated with higher globally sclerotic glomerular density. CONCLUSIONS Nephron hypertrophy and nephrosclerosis are structural characteristics in normal adults that relate differently to clinical characteristics and may reflect kidney function and risk factors via separate but inter-related pathways.
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Affiliation(s)
| | | | | | | | - Emilio D Poggio
- Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland Ohio
| | | | - John C Lieske
- Division of Nephrology and Hypertension, Department of Laboratory Medicine and Pathology
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota; and
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62
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Puelles VG, Douglas-Denton RN, Zimanyi MA, Armitage JA, Hughson MD, Kerr PG, Bertram JF. Glomerular hypertrophy in subjects with low nephron number: contributions of sex, body size and race. Nephrol Dial Transplant 2014; 29:1686-95. [PMID: 24792374 DOI: 10.1093/ndt/gfu088] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We have shown that low nephron number (Nglom) is a strong determinant of individual glomerular volume (IGV) in male Americans. However, whether the same pattern is present in female Americans remains unclear. The contributions of body surface area (BSA) and race to IGV in the context of Nglom also require further evaluation. METHODS Kidneys without overt renal disease were collected at autopsy in Mississippi, USA. The extremes of female Nglom were used to define high and low Nglom for both sexes. Nglom and IGV were estimated by design-based stereology. A total of 24 African and Caucasian American females (n = 12 per race; 6 per Nglom extreme) were included. These subjects were subsequently matched to 24 comparable males by age and Nglom and to 18 additional males by age, Nglom and BSA. RESULTS IGV average and variance were very similar in female African and Caucasian Americans with high and low Nglom. Males with low Nglom from both races showed greater IGV average and variance than comparable females matched by age and Nglom. These differences in IGV between sexes were not observed in Caucasian Americans with low Nglom that were matched by age, Nglom and BSA. In contrast, glomeruli from African Americans were larger than those from Caucasian Americans, especially in subjects with high Nglom. CONCLUSIONS While female Americans with low Nglom did not show glomerular hypertrophy, comparable males with low Nglom showed marked glomerular hypertrophy that was closely associated with high BSA. Glomerular size in African Americans may be confounded by multiple additional factors.
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Affiliation(s)
- Victor G Puelles
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | | | - Monika A Zimanyi
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia Department of Anatomy and Pathology, James Cook University, Townsville, Australia
| | - James A Armitage
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia School of Medicine (Optometry), Deakin University, Geelong, Australia
| | - Michael D Hughson
- Department of Pathology, University of Mississippi Medical Center, Jackson, USA
| | - Peter G Kerr
- Department of Nephrology, Monash Health, Melbourne, Australia Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - John F Bertram
- Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
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