Biopsy-based estimation of total nephron number in Japanese living kidney donors

Takaya Sasaki, Nobuo Tsuboi, Go Kanzaki, Kotaro Haruhara, Yusuke Okabayashi, Kentaro Koike, Akimitsu Kobayashi, Izumi Yamamoto, Makoto Ogura, Wendy E. Hoy, John F. Bertram, Akira Shimizu, Takashi Yokoo

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Increasing evidence suggests that individuals with low nephron number have an increased lifetime risk of renal insufficiency, thereby emphasizing the importance of evaluating total nephron number in each individual. In recent years, new methods have been described for estimating human total nephron number using a combination of image analysis and renal biopsy, though the reproducibility and accuracy of these methods remain uncertain. This study estimated total nephron number in healthy Japanese subjects using such a method. Methods: Implantation biopsies from 44 living kidney donors were analyzed. Using pre-donation contrast CT angiograms, transplantation donor kidneys were three-dimensionally reconstructed, and total renal cortical volume was estimated. Total nephron number was estimated based on glomerular density in biopsy specimens and total renal cortical volume. The obtained results were analyzed in relation to clinical variables and compared with those of a previously reported Japanese autopsy study. Results: The estimated non-sclerotic and total numbers of glomeruli in this cohort were 650,000 ± 220,000 and 710,000 ± 220,000 (mean ± SD) per kidney. Non-sclerotic glomerular number ranged from 280,000 to 1,220,000 per kidney (4.4-fold) and correlated directly with eGFR (r = 0.328, p = 0.030) and inversely with age (r = − 0.355, p = 0.018). Conclusion: The estimated total nephron number obtained in the present study was 25% less than that reported in American living kidney donors obtained using the same procedure and similar to that obtained in a previous Japanese autopsy study using the disector/fractionator method. These results confirm the feasibility of a combined CT angiography and biopsy-based method to estimate total nephron number in humans.

Original languageEnglish
Number of pages9
JournalClinical and Experimental Nephrology
DOIs
Publication statusAccepted/In press - 1 Jan 2019
EventAnnual Congress of the European-Renal-Association/European-Dialysis-and-Transplant-Association (ERA-EDTA) 2018 - Copenhagen, Denmark
Duration: 24 May 201827 May 2018
Conference number: 55th
http://www.era-edta2018.org/en-US/home

Keywords

  • Angiogram
  • Kidney transplantation
  • Nephron number
  • Renal biopsy

Cite this

Sasaki, T., Tsuboi, N., Kanzaki, G., Haruhara, K., Okabayashi, Y., Koike, K., ... Yokoo, T. (Accepted/In press). Biopsy-based estimation of total nephron number in Japanese living kidney donors. Clinical and Experimental Nephrology. https://doi.org/10.1007/s10157-018-01686-2
Sasaki, Takaya ; Tsuboi, Nobuo ; Kanzaki, Go ; Haruhara, Kotaro ; Okabayashi, Yusuke ; Koike, Kentaro ; Kobayashi, Akimitsu ; Yamamoto, Izumi ; Ogura, Makoto ; Hoy, Wendy E. ; Bertram, John F. ; Shimizu, Akira ; Yokoo, Takashi. / Biopsy-based estimation of total nephron number in Japanese living kidney donors. In: Clinical and Experimental Nephrology. 2019.
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title = "Biopsy-based estimation of total nephron number in Japanese living kidney donors",
abstract = "Background: Increasing evidence suggests that individuals with low nephron number have an increased lifetime risk of renal insufficiency, thereby emphasizing the importance of evaluating total nephron number in each individual. In recent years, new methods have been described for estimating human total nephron number using a combination of image analysis and renal biopsy, though the reproducibility and accuracy of these methods remain uncertain. This study estimated total nephron number in healthy Japanese subjects using such a method. Methods: Implantation biopsies from 44 living kidney donors were analyzed. Using pre-donation contrast CT angiograms, transplantation donor kidneys were three-dimensionally reconstructed, and total renal cortical volume was estimated. Total nephron number was estimated based on glomerular density in biopsy specimens and total renal cortical volume. The obtained results were analyzed in relation to clinical variables and compared with those of a previously reported Japanese autopsy study. Results: The estimated non-sclerotic and total numbers of glomeruli in this cohort were 650,000 ± 220,000 and 710,000 ± 220,000 (mean ± SD) per kidney. Non-sclerotic glomerular number ranged from 280,000 to 1,220,000 per kidney (4.4-fold) and correlated directly with eGFR (r = 0.328, p = 0.030) and inversely with age (r = − 0.355, p = 0.018). Conclusion: The estimated total nephron number obtained in the present study was 25{\%} less than that reported in American living kidney donors obtained using the same procedure and similar to that obtained in a previous Japanese autopsy study using the disector/fractionator method. These results confirm the feasibility of a combined CT angiography and biopsy-based method to estimate total nephron number in humans.",
keywords = "Angiogram, Kidney transplantation, Nephron number, Renal biopsy",
author = "Takaya Sasaki and Nobuo Tsuboi and Go Kanzaki and Kotaro Haruhara and Yusuke Okabayashi and Kentaro Koike and Akimitsu Kobayashi and Izumi Yamamoto and Makoto Ogura and Hoy, {Wendy E.} and Bertram, {John F.} and Akira Shimizu and Takashi Yokoo",
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Sasaki, T, Tsuboi, N, Kanzaki, G, Haruhara, K, Okabayashi, Y, Koike, K, Kobayashi, A, Yamamoto, I, Ogura, M, Hoy, WE, Bertram, JF, Shimizu, A & Yokoo, T 2019, 'Biopsy-based estimation of total nephron number in Japanese living kidney donors' Clinical and Experimental Nephrology. https://doi.org/10.1007/s10157-018-01686-2

Biopsy-based estimation of total nephron number in Japanese living kidney donors. / Sasaki, Takaya; Tsuboi, Nobuo; Kanzaki, Go; Haruhara, Kotaro; Okabayashi, Yusuke; Koike, Kentaro; Kobayashi, Akimitsu; Yamamoto, Izumi; Ogura, Makoto; Hoy, Wendy E.; Bertram, John F.; Shimizu, Akira; Yokoo, Takashi.

In: Clinical and Experimental Nephrology, 01.01.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Biopsy-based estimation of total nephron number in Japanese living kidney donors

AU - Sasaki, Takaya

AU - Tsuboi, Nobuo

AU - Kanzaki, Go

AU - Haruhara, Kotaro

AU - Okabayashi, Yusuke

AU - Koike, Kentaro

AU - Kobayashi, Akimitsu

AU - Yamamoto, Izumi

AU - Ogura, Makoto

AU - Hoy, Wendy E.

AU - Bertram, John F.

AU - Shimizu, Akira

AU - Yokoo, Takashi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Increasing evidence suggests that individuals with low nephron number have an increased lifetime risk of renal insufficiency, thereby emphasizing the importance of evaluating total nephron number in each individual. In recent years, new methods have been described for estimating human total nephron number using a combination of image analysis and renal biopsy, though the reproducibility and accuracy of these methods remain uncertain. This study estimated total nephron number in healthy Japanese subjects using such a method. Methods: Implantation biopsies from 44 living kidney donors were analyzed. Using pre-donation contrast CT angiograms, transplantation donor kidneys were three-dimensionally reconstructed, and total renal cortical volume was estimated. Total nephron number was estimated based on glomerular density in biopsy specimens and total renal cortical volume. The obtained results were analyzed in relation to clinical variables and compared with those of a previously reported Japanese autopsy study. Results: The estimated non-sclerotic and total numbers of glomeruli in this cohort were 650,000 ± 220,000 and 710,000 ± 220,000 (mean ± SD) per kidney. Non-sclerotic glomerular number ranged from 280,000 to 1,220,000 per kidney (4.4-fold) and correlated directly with eGFR (r = 0.328, p = 0.030) and inversely with age (r = − 0.355, p = 0.018). Conclusion: The estimated total nephron number obtained in the present study was 25% less than that reported in American living kidney donors obtained using the same procedure and similar to that obtained in a previous Japanese autopsy study using the disector/fractionator method. These results confirm the feasibility of a combined CT angiography and biopsy-based method to estimate total nephron number in humans.

AB - Background: Increasing evidence suggests that individuals with low nephron number have an increased lifetime risk of renal insufficiency, thereby emphasizing the importance of evaluating total nephron number in each individual. In recent years, new methods have been described for estimating human total nephron number using a combination of image analysis and renal biopsy, though the reproducibility and accuracy of these methods remain uncertain. This study estimated total nephron number in healthy Japanese subjects using such a method. Methods: Implantation biopsies from 44 living kidney donors were analyzed. Using pre-donation contrast CT angiograms, transplantation donor kidneys were three-dimensionally reconstructed, and total renal cortical volume was estimated. Total nephron number was estimated based on glomerular density in biopsy specimens and total renal cortical volume. The obtained results were analyzed in relation to clinical variables and compared with those of a previously reported Japanese autopsy study. Results: The estimated non-sclerotic and total numbers of glomeruli in this cohort were 650,000 ± 220,000 and 710,000 ± 220,000 (mean ± SD) per kidney. Non-sclerotic glomerular number ranged from 280,000 to 1,220,000 per kidney (4.4-fold) and correlated directly with eGFR (r = 0.328, p = 0.030) and inversely with age (r = − 0.355, p = 0.018). Conclusion: The estimated total nephron number obtained in the present study was 25% less than that reported in American living kidney donors obtained using the same procedure and similar to that obtained in a previous Japanese autopsy study using the disector/fractionator method. These results confirm the feasibility of a combined CT angiography and biopsy-based method to estimate total nephron number in humans.

KW - Angiogram

KW - Kidney transplantation

KW - Nephron number

KW - Renal biopsy

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