The Natural History of Residual Renal Function in Transplant Donors

Mueller, Thomas; Luyckx, Valérie A.

doi:10.1681/asn.2011111080

Cited by 52 publications

(51 citation statements)

References 31 publications

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“…Because of this compensatory hypertrophy, the follow-up GFR is usually .50% the predonation GFR (mean of 65% in our study) (41,42). Our study found that the compensatory increase in GFR is less influenced by the baseline size of the nephrons and more influenced by the amount of nephrosclerosis (glomerulosclerosis) present.…”

Section: Discussionmentioning

confidence: 43%

“…Donating a kidney results in hypertrophy of the nephrons in the remaining kidney (41,42). Because of this compensatory hypertrophy, the follow-up GFR is usually .50% the predonation GFR (mean of 65% in our study) (41,42).…”

Section: Discussionmentioning

confidence: 61%

“…Glomerulosclerosis (and nephrosclerosis) may be primarily driven by ischemia from arteriosclerosis with aging and hypertension. Glomerulomegaly (and nephromegaly) may be primarily driven by low nephron endowment at birth and by metabolic stress (obesity and hyperuricemia; Figure 3) (41,42).…”

Section: Discussionmentioning

confidence: 99%

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Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

Elsherbiny

Alexander²,

Kremers³

et al. 2014

Clinical Journal of the American Society of Nephrology

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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 (6SD) age was 44612 years, 24-hour urine albumin excretion was 567 mg, measured GFR was 103617 ml/min per 1.73 m 2 , uric acid was 5.261.4 mg/dl, and body mass index was 2865 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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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 61%

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Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

Elsherbiny

Alexander²,

Kremers³

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…The present study showed that housing of Nx rats in the Egyptian pyramid model induced significant increase in GRF in comparison to sham and Nx rats. This increase suggested predominantly hemodynamic response and more efficient hyper filtration [35,54]. It also appears that the energy field developed within the pyramid may increase the GFR by increase in the renal blood flow that stimulate renin production and enhance RAS system that increasing sodium reuptake.…”

Section: Journal Of Complementary Medicine and Alternative Healthcarementioning

confidence: 98%

“…In conjunction with the reports of Bohlouli et al [53] and Chapman et al [3], the present study revealed significant increase in creatinine clearance following unilateral nephrectomy in rats. Mueller & Luyckx [54] reported increase in GFR by 60%-70% following uni-nephrectomy in the remaining kidney.…”

Section: Journal Of Complementary Medicine and Alternative Healthcarementioning

confidence: 99%

Egyptian Pyramid Model Housing Enhancing the Compensatory Renal Growth in Nephrectomized Rats

Margaret¹

2016

JCMAH

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The present study aims to evaluate the role of the Egyptian pyramids housing on the enhancement of reno-regenerative ability after unilateral nephrectomy in rats. Forty two male Wistar rats were assigned equally into three main groups (14 rats for each).The sham-operated control (sham group) and unilateral nephrectomized rats (Nx group). Both groups maintained in their home cages for 7 and 14 days. The third group(Pyramid housed group) in which Nx rats housed within the wooden pyramid (6 hr/day)for 7 and 14 days. The present study showed significant increase in size of the remaining kidney, rate of sodium excretion and marked increase in urea, uric acid and creatinine levels in the serum of Nx rats. In addition, significant decrease in renin-angiotensin-aldosterone system was also recorded following nephrectomy for 7 and 14 days. Pyramid environment reversed the actions of nephrectomy in rats and restored the kidney function near the sham levels. In conclusion: The present study recommends using pyramidal shapes for nephrectomized individual's rooms immediately following the surgery and during the recovery periods to avoid kidney impairment as consequence of nephrectomy process.

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Clinical consequences of developmental programming of low nephron number

Luyckx

Brenner

2019

The Anatomical Record

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Nephron number in humans varies up to 13‐fold, likely reflecting the impact of multiple factors on kidney development, including inherited body size and ethnicity, as well as maternal health and nutrition, fetal exposure to gestational diabetes or preeclampsia and other environmental factors, which may potentially be modifiable. Such conditions predispose to low or high offspring birth weight, growth restriction or preterm birth, which have all been associated with increased risks of higher blood pressures and/or kidney dysfunction in later life. Low birth weight, preterm birth, and intrauterine growth restriction are associated with reduced nephron numbers. Humans with hypertension and chronic kidney disease tend to have fewer nephrons than their counterparts with normal blood pressures or kidney function. A developmentally programmed reduction in nephron number therefore enhances an individual's susceptibility to hypertension and kidney disease in later life. A low nephron number at birth may not lead to kidney dysfunction alone except when severe, but in the face of superimposed acute or chronic kidney injury, a kidney endowed with fewer nephrons may be less able to adapt, and overt kidney disease may develop. Given that millions of babies are born either too small, too big or too soon each year, the population impact of altered renal programming is likely to be significant. Many gestational exposures are modifiable, therefore urgent attention is required to implement public health measures to optimize maternal, fetal, and child health, to prevent or mitigate the consequences of developmental programming, to improve the health future generations.

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The Natural History of Residual Renal Function in Transplant Donors

Cited by 52 publications

References 31 publications

Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

Nephron Hypertrophy and Glomerulosclerosis and Their Association with Kidney Function and Risk Factors among Living Kidney Donors

Egyptian Pyramid Model Housing Enhancing the Compensatory Renal Growth in Nephrectomized Rats

Clinical consequences of developmental programming of low nephron number

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