Related Experiment Video
Updated: Dec 4, 2025
08:50
5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
24.1K
Nephron Number and Time to Remission in Steroid-Sensitive Minimal Change Disease
Takaya Sasaki1, Nobuo Tsuboi1, Hirokazu Marumoto1
1Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Kidney Medicine
|October 23, 2020
Summary
Patients with minimal change disease (MCD) and fewer nephrons experience a delayed complete remission after corticosteroid therapy. This study highlights nephron number as a key factor influencing treatment response in MCD.
Area of Science:
- Nephrology
- Pathology
Background:
- Corticosteroid therapy response varies in minimal change disease (MCD).
- Previous research suggests a link between glomerular structure (hypertrophy, low density) and treatment outcomes in MCD.
- These structural differences may indicate a reduced nephron count.
Purpose of the Study:
- To investigate the association between estimated nephron number and corticosteroid treatment response in adult patients diagnosed with MCD.
- To determine if nephron count influences the time to achieve complete remission or the rate of relapse.
Main Methods:
- Retrospective cohort study involving 75 adult patients with MCD.
- Nephron number estimated using unenhanced computed tomography and glomerular density from kidney biopsy.
- Multivariable Cox proportional hazard analyses were employed to assess associations between nephron number and treatment outcomes.
Main Results:
- All patients achieved remission with corticosteroid therapy, but those with fewer nephrons had a significantly longer time to complete remission.
- Nephron number was identified as an independent predictor for achieving complete remission (HR 1.10 per 100,000 nephrons).
- Nephron count did not correlate with partial remission achievement or relapse rates.
Conclusions:
- Lower estimated nephron number in patients with MCD is associated with a delayed achievement of complete remission following corticosteroid treatment.
- Nephron number is a significant factor influencing corticosteroid responsiveness in minimal change disease.
- Limitations include the retrospective design and potential sampling bias from needle biopsies.
Related Concept Videos
01:29Acute Kidney Injury III: Clinical Manifestations
525
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
525
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
103
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
103
01:11Renal Failure: Dose Adjustments
300
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
300
01:24Nephrotic Syndrome III : Nursing Management
175
Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
175
01:24Nephrotic Syndrome I : Introduction
308
Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...
308
01:26Nephrotic Syndrome II : Assessment and Medical Management
108
IntroductionNephrotic syndrome is a kidney disorder marked by excessive protein loss in the urine, leading to various systemic complications. This condition often results from damage to the glomeruli—the kidney's filtering units—causing proteinuria, low blood protein levels, and fluid retention. Understanding the assessment, diagnosis, and management of nephrotic syndrome is essential for effective treatment and prevention of further kidney damage.AssessmentPatient History: Document...
108