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...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Kidney International Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024924034673 |
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| 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 |
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