{"title":"使用肾切除标本估算在世儿科患者肾单位数量","authors":"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","doi":"10.1016/j.ekir.2024.12.027","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>ρ</em> = 0.47, <em>P</em> = 0.036) and larger body surface area (BSA; <em>ρ</em> = 0.45, <em>P</em> = 0.034).</div></div><div><h3>Conclusion</h3><div>This study offers new insights into pediatric nephron endowment, emphasizing the importance of early nephron assessment for predicting long-term renal outcomes.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 772-779"},"PeriodicalIF":5.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens\",\"authors\":\"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\",\"doi\":\"10.1016/j.ekir.2024.12.027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>ρ</em> = 0.47, <em>P</em> = 0.036) and larger body surface area (BSA; <em>ρ</em> = 0.45, <em>P</em> = 0.034).</div></div><div><h3>Conclusion</h3><div>This study offers new insights into pediatric nephron endowment, emphasizing the importance of early nephron assessment for predicting long-term renal outcomes.</div></div>\",\"PeriodicalId\":17761,\"journal\":{\"name\":\"Kidney International Reports\",\"volume\":\"10 3\",\"pages\":\"Pages 772-779\"},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kidney International Reports\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468024924034673\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney International Reports","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468024924034673","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
肾单位的数量是肾脏健康的关键决定因素,因为慢性肾脏疾病通常是由功能性肾单位减少引起的。肾单位数量的变异受遗传、种族、产前和产后因素的影响。在年龄相关的肾单位丧失发生之前,估计肾单位的数量对于建立基线至关重要。本研究旨在通过影像学和组织学技术估计儿科患者肾单位的数量。方法本回顾性研究纳入2010年1月至2021年1月期间接受肾切除术和CT增强扫描的儿科肾肿瘤患者。术后肾组织标本固定、染色并扫描成高分辨率数字图像。非硬化肾小球密度采用立体学方法计算,而肾皮质体积采用ITK-SNAP软件在CT图像上测量。根据皮质体积和肾小球密度估计肾单位的总数。统计分析肾单位数量与临床因素的相关性。结果21例患儿符合纳入标准。该队列包括13名男孩(61.9%)和8名女孩(38.1%),肾切除术时的中位年龄为2.5岁。每肾肾单位的中位数为925,000个(四分位数间距[IQR]: 845,000-1,020,000)。较高的肾单位数量与肾切除术时年龄较大(ρ = 0.47, P = 0.036)和较大的体表面积(BSA;ρ = 0.45, p = 0.034)。结论本研究为儿童肾元捐赠提供了新的见解,强调了早期肾元评估对预测长期肾脏预后的重要性。
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 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.
期刊介绍:
Kidney International Reports, an official journal of the International Society of Nephrology, is a peer-reviewed, open access journal devoted to the publication of leading research and developments related to kidney disease. With the primary aim of contributing to improved care of patients with kidney disease, the journal will publish original clinical and select translational articles and educational content related to the pathogenesis, evaluation and management of acute and chronic kidney disease, end stage renal disease (including transplantation), acid-base, fluid and electrolyte disturbances and hypertension. Of particular interest are submissions related to clinical trials, epidemiology, systematic reviews (including meta-analyses) and outcomes research. The journal will also provide a platform for wider dissemination of national and regional guidelines as well as consensus meeting reports.