Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens

Introduction: The number of nephrons is a critical determinant of renal health, because chronic kidney disease often results from a reduction in functional nephrons. Variability in the number of nephrons is influenced by genetic, racial, prenatal, and postnatal factors. Estimating the number of neph...

Full description

Saved in:
Bibliographic Details
Main Authors: Haruhide Sakaguchi, Daishi Hirano, Yuhei Kawakami, Ai Tokunaga, Naoto Nishizaki, Amane Endo, Hiroki Miyano, Yuki Yuza, Saeko Hatanaka, Takaya Sasaki, Go Kanzaki, Nobuo Tsuboi, Kimihiko Oishi
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Kidney International Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924034673
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850126808138121216
author Haruhide Sakaguchi
Daishi Hirano
Yuhei Kawakami
Ai Tokunaga
Naoto Nishizaki
Amane Endo
Hiroki Miyano
Yuki Yuza
Saeko Hatanaka
Takaya Sasaki
Go Kanzaki
Nobuo Tsuboi
Kimihiko Oishi
author_facet Haruhide Sakaguchi
Daishi Hirano
Yuhei Kawakami
Ai Tokunaga
Naoto Nishizaki
Amane Endo
Hiroki Miyano
Yuki Yuza
Saeko Hatanaka
Takaya Sasaki
Go Kanzaki
Nobuo Tsuboi
Kimihiko Oishi
author_sort Haruhide Sakaguchi
collection DOAJ
description Introduction: The number of nephrons is a critical determinant of renal health, because chronic kidney disease often results from a reduction in functional nephrons. Variability in the number of nephrons is influenced by genetic, racial, prenatal, and postnatal factors. Estimating the number of nephrons is crucial for establishing a baseline, before the onset of age-related nephron loss. This study aimed to estimate number of nephrons in pediatric patients by using imaging and histological techniques. Methods: This retrospective study included pediatric patients with renal tumors, who are undergoing nephrectomy and contrast-enhanced computed tomography (CT) between January 2010 and January 2021. Postsurgical renal tissue specimens were fixed, stained, and scanned into high-resolution digital images. Nonsclerotic glomerular density was calculated using stereological methods, whereas renal cortical volume was measured using ITK-SNAP software on CT images. The total number of nephrons was estimated based on cortical volume and glomerular density. Statistical analyses were conducted to identify the correlations between the number of nephrons and clinical factors. Results: Twenty-one children met the inclusion criteria. The cohort comprised 13 boys (61.9%) and 8 girls (38.1%) with a median age at nephrectomy of 2.5 years. The median number of nephrons per kidney was 925,000 (interquartile range [IQR]: 845,000–1,020,000). Higher number of nephrons was significantly correlated with older age at nephrectomy (ρ = 0.47, P = 0.036) and larger body surface area (BSA; ρ = 0.45, P = 0.034). Conclusion: This study offers new insights into pediatric nephron endowment, emphasizing the importance of early nephron assessment for predicting long-term renal outcomes.
format Article
id doaj-art-69c2c8aa788a481ab6f9ab46d768b6ad
institution OA Journals
issn 2468-0249
language English
publishDate 2025-03-01
publisher Elsevier
record_format Article
series Kidney International Reports
spelling doaj-art-69c2c8aa788a481ab6f9ab46d768b6ad2025-08-20T02:33:51ZengElsevierKidney International Reports2468-02492025-03-0110377277910.1016/j.ekir.2024.12.027Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy SpecimensHaruhide Sakaguchi0Daishi Hirano1Yuhei Kawakami2Ai Tokunaga3Naoto Nishizaki4Amane Endo5Hiroki Miyano6Yuki Yuza7Saeko Hatanaka8Takaya Sasaki9Go Kanzaki10Nobuo Tsuboi11Kimihiko Oishi12Department of Pediatrics, The Jikei University School of Medicine, Tokyo, JapanDepartment of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan; Correspondence: Daishi Hirano, Department of Pediatrics, The Jikei University School of Medicine; 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, Japan.Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, JapanDepartment of Pediatrics, Loco Clinic, Tokyo, JapanDepartment of Pediatrics, Juntendo University Urayasu Hospital, Urayasu, JapanDepartment of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine, Tokyo, JapanDepartment of Pediatrics, Juntendo University Nerima Hospital, Tokyo, JapanDepartment of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, JapanDepartment of Pediatrics, The Jikei University School of Medicine, Tokyo, JapanIntroduction: The number of nephrons is a critical determinant of renal health, because chronic kidney disease often results from a reduction in functional nephrons. Variability in the number of nephrons is influenced by genetic, racial, prenatal, and postnatal factors. Estimating the number of nephrons is crucial for establishing a baseline, before the onset of age-related nephron loss. This study aimed to estimate number of nephrons in pediatric patients by using imaging and histological techniques. Methods: This retrospective study included pediatric patients with renal tumors, who are undergoing nephrectomy and contrast-enhanced computed tomography (CT) between January 2010 and January 2021. Postsurgical renal tissue specimens were fixed, stained, and scanned into high-resolution digital images. Nonsclerotic glomerular density was calculated using stereological methods, whereas renal cortical volume was measured using ITK-SNAP software on CT images. The total number of nephrons was estimated based on cortical volume and glomerular density. Statistical analyses were conducted to identify the correlations between the number of nephrons and clinical factors. Results: Twenty-one children met the inclusion criteria. The cohort comprised 13 boys (61.9%) and 8 girls (38.1%) with a median age at nephrectomy of 2.5 years. The median number of nephrons per kidney was 925,000 (interquartile range [IQR]: 845,000–1,020,000). Higher number of nephrons was significantly correlated with older age at nephrectomy (ρ = 0.47, P = 0.036) and larger body surface area (BSA; ρ = 0.45, P = 0.034). Conclusion: This study offers new insights into pediatric nephron endowment, emphasizing the importance of early nephron assessment for predicting long-term renal outcomes.http://www.sciencedirect.com/science/article/pii/S2468024924034673childrenglomerular filtration ratekidney biopsynephron numbersingle nephron GFR
spellingShingle Haruhide Sakaguchi
Daishi Hirano
Yuhei Kawakami
Ai Tokunaga
Naoto Nishizaki
Amane Endo
Hiroki Miyano
Yuki Yuza
Saeko Hatanaka
Takaya Sasaki
Go Kanzaki
Nobuo Tsuboi
Kimihiko Oishi
Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens
Kidney International Reports
children
glomerular filtration rate
kidney biopsy
nephron number
single nephron GFR
title Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens
title_full Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens
title_fullStr Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens
title_full_unstemmed Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens
title_short Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens
title_sort estimating number of nephrons in living pediatric patients using nephrectomy specimens
topic children
glomerular filtration rate
kidney biopsy
nephron number
single nephron GFR
url http://www.sciencedirect.com/science/article/pii/S2468024924034673
work_keys_str_mv AT haruhidesakaguchi estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT daishihirano estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT yuheikawakami estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT aitokunaga estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT naotonishizaki estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT amaneendo estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT hirokimiyano estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT yukiyuza estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT saekohatanaka estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT takayasasaki estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT gokanzaki estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT nobuotsuboi estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens
AT kimihikooishi estimatingnumberofnephronsinlivingpediatricpatientsusingnephrectomyspecimens