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Estimation of Nephron Number in Whole Kidney using the Acid Maceration Method
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Low glomerular number at birth can lead to the development of chronic kidney disease

Shohei Fukunaga1, Yuki Fujita2

  • 1Division of Nephrology, Shimane University Hospital, Izumo, Shimane, Japan.

Frontiers in Endocrinology
|February 13, 2023
PubMed

Insights

Maternal malnutrition in early development can reduce the number of glomeruli, increasing the lifelong risk of chronic kidney disease (CKD). Maintaining glomerular number at birth is crucial for kidney health.

Area of Science:

  • Nephrology
  • Developmental Biology
  • Public Health

Background:

  • Chronic kidney disease (CKD) prevalence is rising globally.
  • Early life environmental factors, including maternal nutrition, impact kidney development.
  • Reduced glomerular number in infancy is linked to increased CKD risk.

Purpose of the Study:

  • To investigate the impact of maternal malnutrition on glomerular development.
  • To understand the mechanisms leading to reduced glomerular number.
  • To emphasize the importance of maintaining glomerular count for lifelong kidney health.

Main Methods:

  • Review of mechanisms linking maternal malnutrition to reduced ureteric bud branching and glomerular formation.
  • Discussion of four proposed pathways: c-Ret suppression, RAAS inhibition, glucocorticoid exposure, and apoptosis promotion.
  • Highlighting advancements in glomerular counting techniques (CT, MRI) and established methods (dissector/fractionator).

Main Results:

  • Maternal malnutrition reduces infant glomerular number by affecting ureteric bud branching.
  • This reduction is attributed to mechanisms including suppressed c-Ret expression and increased apoptosis.
  • A lower glomerular count at birth represents a permanent burden, elevating CKD risk.

Conclusions:

  • Glomerular number is established early and cannot be increased postnatally in humans.
  • Preventing reduced glomerular number during fetal development is critical for mitigating CKD.
  • Accurate glomerular counting methods are essential for research and understanding CKD origins.

Keywords:
chronic kidney diseaseglomerular numberlow birth weightmaternal malnutritionnephron development

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