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Estimating individual glomerular volume in the human kidney : clinical perspectives

Puelles, Victor G., Zimanyi, Monika A., Samuel, Terence, Hughson, Michael D., Douglas-Denton, Rebecca N., Bertram, John F. and Armitage, James A. 2012, Estimating individual glomerular volume in the human kidney : clinical perspectives, Nephrology, Dialysis, Transplantation, vol. 27, no. 5, pp. 1880-1888, doi: 10.1093/ndt/gfr539.

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Title Estimating individual glomerular volume in the human kidney : clinical perspectives
Author(s) Puelles, Victor G.
Zimanyi, Monika A.
Samuel, Terence
Hughson, Michael D.
Douglas-Denton, Rebecca N.
Bertram, John F.
Armitage, James A.
Journal name Nephrology, Dialysis, Transplantation
Volume number 27
Issue number 5
Start page 1880
End page 1888
Total pages 9
Publisher Oxford University Press
Place of publication Oxford, England
Publication date 2012-05
ISSN 0931-0509
Keyword(s) glomerular heterogeneity
glomerular volume
glomerular size
Summary Background. Measurement of individual glomerular volumes (IGV) has allowed the identification of drivers of glomerular hypertrophy in subjects without overt renal pathology. This study aims to highlight the relevance of IGV measurements with possible clinical implications and determine how many profiles must be measured in order to achieve stable size distribution estimates.

Methods. We re-analysed 2250 IGV estimates obtained using the disector/Cavalieri method in 41 African and 34 Caucasian Americans. Pooled IGV analysis of mean and variance was conducted. Monte-Carlo (Jackknife) simulations determined the effect of the number of sampled glomeruli on mean IGV. Lin’s concordance coefficient (RC), coefficient of variation (CV) and coefficient of error (CE) measured reliability.

Results. IGV mean and variance increased with overweight and hypertensive status. Superficial glomeruli were significantly smaller than juxtamedullary glomeruli in all subjects (P < 0.01), by race (P < 0.05) and in obese individuals (P < 0.01). Subjects with multiple chronic kidney disease (CKD) comorbidities showed significant increases in IGV mean and variability. Overall, mean IGV was particularly reliable with nine or more sampled glomeruli (RC > 0.95, <5% difference in CV and CE). These observations were not affected by a reduced sample size and did not disrupt the inverse linear correlation between mean IGV and estimated total glomerular number.

Conclusions.
Multiple comorbidities for CKD are associated with increased IGV mean and variance within subjects, including overweight, obesity and hypertension. Zonal selection and the number of sampled glomeruli do not represent drawbacks for future longitudinal biopsy-based studies of glomerular size and distribution.
Language eng
DOI 10.1093/ndt/gfr539
Field of Research 110312 Nephrology and Urology
Socio Economic Objective 920119 Urogenital System and Disorders
HERDC Research category C1.1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30050711

Document type: Journal Article
Collection: School of Medicine
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