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Distribution of volumes of different glomeruli within individuals: Findings in kidneys at coronial autopsy

This paper was not found in any repository; the policy of its publisher is unknown or unclear.
This paper was not found in any repository; the policy of its publisher is unknown or unclear.

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Abstract

Aim: To describe the distribution of volumes of different glomeruli in individuals (IgV), and some associations. Background: Existing studies describe correlations of glomerular volume with age, with nephron number and birthweight, inversely, and with adult body size and hypertension. However, those are derived estimates of glomerular volume, and only a single value is generated per kidney. We measured the volume of multiple glomeruli without sclerosis in the right kidney of adult white males in Jackson, MS, undergoing autopsy for sudden or unexpected death. They had no gross renal abnormalities, and no documented renal disease. Methods: Volumes of 30 glomeruli, 10 from the outer, middle and inner cortical zones, were measured by the Cavalieri method. Results were evaluated by age (20–30 and 60–70 years), nephron number (top and bottom quintiles), birthweight (top and bottom quintiles), BMI (35 kg/m2) and by hypertension, with six subjects (and 180 glomeruli) in each category. IgV and IgV variances were compared in aggregate and again, among individuals. Results: In aggregate, IgV (mean, SD) was greater with higher age, 4.0(1.3) vs 3.7(1.2), p = 0.01, lower nephron number, 6.4(0.2) vs 3.0(0.1), p ≤ 0.0001, lower birthweight, 5.2(2.1) vs 3.7(1.4), p ≤ 0.0001, higher BMI, 5.0(0.1) vs 3.5(0.1), p ≤ 0.0001, and hypertension, 4.7(0.1) vs 4.1(0.1), p = 0.0003. In groups of individuals, the differences remained significant for nephron number and BMI (p ≤ 0.001), and, marginally, for birthweight (p = 0.06). However, IgV variances were significantly larger in those of higher age (p = 0.007), lower nephron number (p = 0.007) and higher BMI, (p = 0.02), than their comparator groups. Conclusions: Hypertrophic stress, marked by greater mean glomerular volume and volume heterogeneity, is differently expressed among different glomeruli within individuals. Excessive enlargement probably marks the pathway to glomerulosclerosis.