Division of Kidney and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Pathol Int. 2013 Mar;63(3):169-75. doi: 10.1111/pin.12044. Epub 2013 Mar 15.
Our studies have demonstrated that a low glomerular density in renal biopsies is a plausible predictor of a worse renal outcome in patients with primary glomerular diseases. However, there remains a concern regarding the diversity that may exist in the distribution of glomerular density within the same kidney. This study therefore aimed to determine the differences in the glomerular density between anatomically different cortical zones of the human kidney. A total of 89 autopsy kidneys were analyzed to accurately measure the glomerular density in different parts of the renal cortex. As a whole, compared to the glomerular density in the superficial cortex (3.0 ± 0.7/mm(2)), the average glomerular density in the juxtamedullary cortex (2.2 ± 0.6/mm(2)) was approximately two-thirds. The glomerular density showed maximal 3.5-fold variations between individuals and was inversely correlated with the mean glomerular volume in both cortical areas. A low glomerular density of the superficial cortex was predominantly associated with the increase of global glomerulosclerosis. On the other hand, a low glomerular density of the juxtamedullary cortex was predominantly associated with an increase in the kidney weight. Thus, there are significant zonal differences in the distribution of the glomerular density in human kidneys independent of the potential variations observed between individuals.
我们的研究表明，肾活检中肾小球密度低是原发性肾小球疾病患者肾脏预后不良的一个合理预测指标。然而，人们仍然担心同一肾脏内肾小球密度的分布可能存在多样性。因此，本研究旨在确定人肾不同解剖皮质区之间肾小球密度的差异。对 89 例尸检肾脏进行分析，以准确测量肾皮质不同部位的肾小球密度。总的来说，与浅层皮质（3.0±0.7/mm2）的肾小球密度相比，近髓质皮质（2.2±0.6/mm2）的平均肾小球密度约为三分之二。肾小球密度在个体之间的变化最大可达 3.5 倍，与两个皮质区的平均肾小球体积呈负相关。浅层皮质的肾小球密度低主要与全球肾小球硬化的增加有关。另一方面，近髓质皮质的肾小球密度低主要与肾脏重量的增加有关。因此，人肾肾小球密度的分布存在显著的区域性差异，而个体之间的潜在差异则独立存在。
