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Updated: Jan 22, 2026
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Estimation of Nephron Number in Whole Kidney using the Acid Maceration Method
Published on: May 22, 2019
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Changing Protein Permeability with Nephron Loss: Evidence for a Human Remnant Nephron Effect
Jamie Willows1, Aghogho Odudu2, Ian Logan1,3
1Newcastle upon Tyne Teaching Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
American Journal of Nephrology
|July 4, 2019
Summary
Nephron loss increases kidney protein permeability, even without primary glomerular disease. This supports the "remnant nephron" theory in chronic kidney disease (CKD) progression.
Area of Science:
- Nephrology
- Renal Physiology
- Glomerular Filtration
Background:
- Loss of functioning nephrons may lead to glomerular barotrauma, a
Purpose of the Study:
- To investigate the relationship between nephron loss and renal protein permeability in humans.
- To determine if glomerular permeability increases as glomerular filtration rate (GFR) declines.
Main Methods:
- Measured changes in net renal protein permeability (proteinuria or albuminuria per mL/min GFR).
- Analyzed data from kidney donors and patients with progressive chronic kidney disease (CKD) across multiple cohorts (Assessing Long Term Outcomes in Living Kidney Donors, MDRD, AASK, CRIC).
Main Results:
- Renal albumin permeability increased by 31% after kidney donation.
- Progressive CKD showed significant increases in proteinuria per mL/min GFR (1.6- to 2.1-fold) with a 50% GFR loss.
- A 70% GFR reduction was associated with 2.6- to 4.4-fold increases in permeability, independent of blood pressure and ACEi/ARB use.
- In non-glomerular disease, increased permeability suggested de novo glomerular pathology as GFR fell.
- No permeability increase was observed without a fall in GFR.
Conclusions:
- Nephron loss is associated with increased renal protein permeability in humans.
- This finding supports the
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