Zimanyi Monika A, Hoy Wendy E, Douglas-Denton Rebecca N, Hughson Michael D, Holden Libby M, Bertram John F
Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Monash University, Victoria, Australia.
Nephrol Dial Transplant. 2009 Aug;24(8):2428-33. doi: 10.1093/ndt/gfp116. Epub 2009 Mar 18.
Glomerular hypertrophy has been described in several populations at high risk of chronic kidney disease. Total nephron (and thereby glomerular) number (N(glom)) varies widely in normal adult human kidneys and is generally inversely correlated with mean glomerular volume (V(glom)). However, little is known about the range of individual glomerular volumes (IV(glom)) within single human kidneys and the association with N(glom). The aim of the present study was to estimate IV(glom) in Caucasian and African Americans and identify any associations between heterogeneity in IV(glom) and nephron number.
Using unbiased stereological techniques, IV(glom) was determined for 30 glomeruli in each of 24 adult male kidneys from Jackson, MS, USA (12 Caucasian and 12 African American). Half of each group had 'high' N(glom) (>1.2 million nephrons per kidney) and the other half had 'low' N(glom) (<600 000).
Caucasians with high N(glom) had a relatively homogeneous distribution of IV(glom) as well as a relatively low mean value, while those with low N(glom) had much greater heterogeneity of IV(glom), as well as a larger IV(glom) (P < 0.0001) compared with those with high N(glom). This disparity was not apparent in African Americans, however, where subjects with both high and low N(glom) showed substantial heterogeneity in IV(glom) and larger mean values (P = 0.95).
High N(glom) appeared to protect against glomerular enlargement and volume heterogeneity in Caucasians. However, substantial variation in IV(glom) and net enlargement in glomerular size in African Americans with high nephron numbers suggest that additional forces, independent of low N(glom), are driving glomerular enlargement and heterogeneity.
在几个慢性肾病高危人群中已描述了肾小球肥大。正常成年人类肾脏中总肾单位(以及由此而来的肾小球)数量(Nglom)差异很大,并且通常与平均肾小球体积(Vglom)呈负相关。然而,关于单个人类肾脏内单个肾小球体积(IVglom)的范围以及与Nglom的关联知之甚少。本研究的目的是估计白种人和非裔美国人的IVglom,并确定IVglom异质性与肾单位数量之间的任何关联。
使用无偏立体学技术,对来自美国密西西比州杰克逊的24个成年男性肾脏(12名白种人和12名非裔美国人)中每个肾脏的30个肾小球测定IVglom。每组中的一半有“高”Nglom(每个肾脏>120万个肾单位),另一半有“低”Nglom(<600000)。
Nglom高的白种人IVglom分布相对均匀,平均值也相对较低,而Nglom低的白种人IVglom异质性大得多,并且与Nglom高的白种人相比IVglom更大(P<0.0001)。然而,这种差异在非裔美国人中并不明显,在非裔美国人中,Nglom高和低的受试者IVglom均表现出显著的异质性且平均值更大(P = 0.95)。
高Nglom似乎可防止白种人中肾小球增大和体积异质性。然而,肾单位数量高的非裔美国人IVglom有很大差异且肾小球大小有净增大,这表明除了低Nglom之外,还有其他因素在驱动肾小球增大和异质性。