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. 2003 Jan 9;348(2):101-8.
doi: 10.1056/NEJMoa020549.

Nephron number in patients with primary hypertension

Gunhild Keller  1 , Gisela Zimmer, Gerhard Mall, Eberhard Ritz, Kerstin Amann
Affiliations
Free article

Nephron number in patients with primary hypertension

Gunhild Keller et al. N Engl J Med. .
Free article

Abstract

Background: A diminished number of nephrons has been proposed as one of the factors contributing to the development of primary hypertension.

Methods: To test this hypothesis, we used a three-dimensional stereologic method to compare the number and volume of glomeruli in 10 middle-aged white patients (age range, 35 to 59 years) with a history of primary hypertension or left ventricular hypertrophy (or both) and renal arteriolar lesions with the number and volume in 10 normotensive subjects matched for sex, age, height, and weight. All 20 subjects had died in accidents.

Results: Patients with hypertension had significantly fewer glomeruli per kidney than matched normotensive controls (median, 702,379 vs. 1,429,200). Patients with hypertension also had a significantly greater glomerular volume than did the controls (median, 6.50x10(-3) mm3 vs. 2.79x10(-3) mm3; P<0.001) but very few obsolescent glomeruli.

Conclusions: The data support the hypothesis that the number of nephrons is reduced in white patients with primary hypertension.

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Comment in

  • Is microanatomy destiny?
    Ingelfinger JR. Ingelfinger JR. N Engl J Med. 2003 Jan 9;348(2):99-100. doi: 10.1056/NEJMp020168. N Engl J Med. 2003. PMID: 12519919 No abstract available.
  • Nephron number and primary hypertension.
    Johnson RJ, Rodríguez-Iturbe B, Herrera-Acosta J. Johnson RJ, et al. N Engl J Med. 2003 Apr 24;348(17):1717-9; author reply 1717-9. doi: 10.1056/NEJM200304243481717. N Engl J Med. 2003. PMID: 12711751 No abstract available.
  • Nephron number and primary hypertension.
    O'Neill WC. O'Neill WC. N Engl J Med. 2003 Apr 24;348(17):1717-9; author reply 1717-9. N Engl J Med. 2003. PMID: 12712999 No abstract available.
  • Nephron number and primary hypertension.
    Querfeld U, Niaudet P. Querfeld U, et al. N Engl J Med. 2003 Apr 24;348(17):1717-9; author reply 1717-9. N Engl J Med. 2003. PMID: 12713000 No abstract available.

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