OBJECTIVE
To test the hypothesis that kidney function and metabolic risk factors are associated
with glomerular density on renal biopsy samples from healthy adults.
PATIENTS AND METHODS
This study compared glomerular density with predonation kidney function, blood pressure,
and metabolic risk factors in living kidney donors at Mayo Clinic in Rochester, MN,
from May 10, 1999, to February 4, 2009. During implantation of the kidney allograft,
an 18-gauge core needle biopsy sample of the renal cortex was obtained, sectioned,
and examined by pathologists. Glomerular density was determined by the number of glomeruli
(normal and sclerotic) divided by area of cortex.
RESULTS
The study sample of 1046 kidney donors had a mean of 21 glomeruli (0.8 sclerotic glomeruli)
and a glomerular density of 2.3 glomeruli per square millimeter. In a subset of 54
donors, glomerular density inversely correlated with the mean glomerular area (rs=−0.28). Independent predictors of decreased glomerular density were older age, increased
glomerular filtration rate, family history of end-stage renal disease, increased serum
uric acid, and increased body mass index. Increased urine albumin excretion, hypertension,
decreased high-density lipoprotein cholesterol, and metabolic syndrome were also associated
with decreased glomerular density after age-sex adjustment. These associations were
not explained by the presence of glomerulosclerosis, tubular atrophy, interstitial
fibrosis, or arteriosclerosis on the renal biopsy sample. In older donors, decreased
glomerular density was attenuated by an increased prevalence of glomerulosclerosis
and tubular atrophy.
CONCLUSION
Decreased glomerular density is associated with many different kidney function and
metabolic risk factors among relatively healthy adults and may represent an early
state of increased risk of parenchymal injury.
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Article Info
Footnotes
This study was supported with funding from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK 090358 and K23 DK078229).
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© 2011 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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- The Aging Kidney: More Pieces to the PuzzleMayo Clinic ProceedingsVol. 86Issue 4
- PreviewIn 1973, Darmady et al1 published a now “classic” article entitled “The Parameters of the Ageing Kidney.” In this autopsy study, the authors evaluated kidney tissue samples from 105 individuals, from birth to 101 years, who had died suddenly and in whom known renal disease or hypertension was absent. The main findings included a gradual shrinking of nephron volume beginning after the third or fourth decade of life and preservation of the ratio of glomerular surface area to proximal tubule volume (ratio of about 3:1) throughout the life span.
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