The Clinical Importance of Nephron Mass : Journal of the American Society of Nephrology (original) (raw)
UP FRONT MATTERS: Brief Review
*Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada; and
†Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
Correspondence: Dr. Valerie A. Luyckx, HMRC 260, University of Alberta, Edmonton, Canada, T6G 2S2. Phone: 780-407-6069; Fax: 780-407-8488; E-mail: [email protected]
Abstract
Abundant evidence supports the association between low birth weight (LBW) and renal dysfunction in humans. Anatomic measurements of infants, children, and adults show significant inverse correlation between LBW and nephron number. Nephron numbers are also lower in individuals with hypertension compared with normotension among white and Australian Aboriginal populations. The relationship between nephron number and hypertension among black individuals is still unclear, although the high incidence of LBW predicts low nephron number in this population as well. LBW, a surrogate for low nephron number, also associates with increasing BP from childhood to adulthood and increasing risk for chronic kidney disease in later life. Because nephron numbers can be counted only postmortem, surrogate markers such as birth weight, prematurity, adult height, reduced renal size, and glomerulomegaly are potentially useful for risk stratification, for example, during living-donor assessment. Because early postnatal growth also affects subsequent risk for higher BP or reduced renal function, postnatal nutrition, a potentially modifiable factor, in addition to intrauterine effects, has significant influence on long-term cardiovascular and renal health.
Copyright © 2010 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
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