Hypertension (HT) and low nephron number confirmed: Results of a coronial autopsy study

Samuel, T., Hughson, M. D., Hoy, W. E., Douglas-Denton, R. and Bertram, J. F. (2004). Hypertension (HT) and low nephron number confirmed: Results of a coronial autopsy study. In: Nephrology: 40th Annual Scientific Meeting of the Australian & New Zealand Society of Nephrology. 40th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology, Adelaide Convention Centre, Adelaide, Australia, (A11-A11). 1–3 September, 2004.


Author Samuel, T.
Hughson, M. D.
Hoy, W. E.
Douglas-Denton, R.
Bertram, J. F.
Title of paper Hypertension (HT) and low nephron number confirmed: Results of a coronial autopsy study
Conference name 40th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology
Conference location Adelaide Convention Centre, Adelaide, Australia
Conference dates 1–3 September, 2004
Proceedings title Nephrology: 40th Annual Scientific Meeting of the Australian & New Zealand Society of Nephrology   Check publisher's open access policy
Place of Publication Carlton, Vic. Australia
Publisher Blackwell Science
Publication Year 2004
ISSN 1320-5358
1440-1797
Volume 9
Issue Supp. 1
Start page A11
End page A11
Total pages 1
Language eng
Abstract/Summary Background: Keller et al. described lower nephron numbers in 10 European adults with documented hypertension (NEJM, 2003) and Brenner et al. proposed earlier that nephron underendowment might be driving the hypertensive state (AJKD, 1995). We examined a larger series in the USA of autopsies following sudden or unexpected death for such an association. Methods: Isolation of the right kidney and the stereologic estimates of glomerular numbers (Nglom) and mean corpuscle volume (Vcorp) by the disector/fractionator combination have been described previously (Bertram, KI, 2001). Where possible, participants were categorized from review of medical and autopsy records as hypertensive- having two or three of the following features: a formal diagnosis, an elevated BP and an enlarged heart at autopsy or not hypertensive: none of these features. Results: So far, 80 participants have reliable data on hypertension: 44 Blacks and 36 Whites, 51 males and 29 females, ages 27–68 year, mean 44 year. Findings: (means, 95%CI) are shown below, adjusted for age, sex and race. People with hypertension were larger (P = 0.024), and had heavier kidneys (P = 0.003), but had significantly fewer glomeruli (about 30% fewer), which were of larger mean estimated volume (about 30% larger), p < 0.0001 for both. Birthweights, available in 42 people, did not differ by hypertension status. In multivariate analysis, significant independent predictors of glomerular number were hypertension, birthweight and gender (females had fewer), but not age or race. Discussion: The study confirms substantially lower nephron numbers and larger glomeruli in people with hypertension. We cannot, however, comment on cause and effect. Our data do not suggest that lower birth weight is the major driving force in the reduced nephron number in the hypertensive group.
Subjects 110312 Nephrology and Urology
1103 Clinical Sciences
Keyword Hypertension
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown

 
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Created: Wed, 17 Mar 2010, 11:00:54 EST by Therese Egan on behalf of Faculty Of Health Sciences