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

Clinical journal of the American Society of Nephrology: CJASN

Kentaro Koike⁴ 

[1]and..

[2]and..*Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

[3]and..†Department of Pediatrics, Niigata University Medical and Dental Hospital, Niigata, Japan..*Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

[4]*Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

关键词: premature birth;    biopsy;    kidney glomerulus;    birth weight;    blood pressure;    body mass index;    child;    female;    gestational age;    glomerulosclerosis, focal segmental;    humans;    infant, low birth weight;    infant, newborn;    kidney;    kidney glomerulus;    nephrons;    nephrosis, lipoid;    pregnancy;    premature birth;    proteinuria;    sclerosis;    segmental glomerulosclerosis;   

DOI  :  10.2215/CJN.05650516

学科分类：泌尿医学

来源: American Society of Nephrology

【 摘 要 】

Background and objectives A low total nephron number, which is associated with low birth weight (LBW), may indicate increased susceptibility to early-onset renal diseases in children. However, few studies have assessed renal biopsy findings in LBW children. We examined the relationship between LBW and glomerular density (GD) and/or glomerular volume (GV) in renal biopsy samples as a surrogate for total nephron number.Design, setting, participants, & measurements Renal biopsy findings of children of LBW were compared with those of age-matched control subjects of normal birth weight (NBW) who were histopathologically diagnosed with FSGS or minimal change nephrotic syndrome (MCNS) from 1995 to 2011. The GD and GV were estimated on the basis of measurements obtained by computerized image analysis.Results A total of 31 subjects (mean age 11 years; eight with low birth weight–FSGS [LBW-FSGS], 10 with normal birth weight–FSGS [NBW-FSGS], and 13 with normal birth weight–minimal change nephrotic syndrome [NBW-MCNS]) were analyzed. The mean birth weight of each group was 777 g (629–1000), 3110 g (2888–3358), and 3120 g (2748–3398), respectively (median [25th–75th percentile]). Age, body mass index, BP, and degrees of globally sclerotic glomeruli at biopsy were comparable between the groups. The GD was lower (LBW-FSGS, 1.4±0.6/mm2; NBW-FSGS, 3.3±1.2/mm2; and NBW-MCNS, 3.6±1.1/mm2; P<0.05) and the GV was greater (LBW-FSGS, 4.1 [3.1–5.1]×106 µm3; NBW-FSGS, 1.6 [1.5–2.1]×106 µm3; and NBW-MCNS, 1.3 [1.1–1.8]×106 µm3 [median, (25th–75th percentile)]; P<0.05) in patients with LBW-FSGS than in the other patient groups. The GD showed close positive correlations with birth weight (r=0.48) and gestational age (r=0.54), independent of renal function and degree of global glomerular sclerosis.Conclusions A low GD together with marked glomerular enlargement characterizes renal biopsy samples of children born with a LBW at an early stage of gestation.

【 授权许可】

CC BY