TY - JOUR
T1 - Glomerular cell number in normal subjects and in type 1 diabetic patients
AU - Steffes, Michael W.
AU - Schmidt, Derek
AU - McCrery, Rebecca
AU - Basgen, John M.
AU - Drummond, Keith
AU - Aebi, Christine
AU - Belmonte, Mimi
AU - Gardiner, Robert
AU - Goodyear, Paul
AU - Kramer, Michael
AU - Polychronakos, Constantin
AU - Suissz, Samy
AU - Laforte, Diane
AU - Braaten, Jan
AU - Fautht, Kenneth
AU - Khoury, Khalil
AU - Czernichow, Paul
AU - Beaudoin, Veronique
AU - Beaufils, Helen
AU - Levy-Marchal, Claire
AU - Gubler, Marie Claire
AU - Passa, Phillippe
AU - Simon, Dominique
AU - Mauer, Michael
AU - Chavers, Blanche
AU - Hostetter, Thomas
AU - Kim, Youngki
AU - Manske, Connie
AU - Michael, Alfred
AU - Saxena, Krisha
AU - Sinaiko, Alan
AU - Vernier, Robert
AU - Strand, Trudy
AU - Bergenstal, Richard
AU - Sockalosky, Joseph
AU - Rich, Stephen
N1 - Funding Information:
This work was supported by the National Institutes of Health (RO1-43605) and the American Diabetes Association. Preliminary data were presented at the meeting of the European Diabetic Nephropathy Study Group (EDNSG) on May 12, 2000, Lund, Sweden. Discussions and insights from Timothy Meyer greatly improved the manuscript. We thank Ms. Carol El-Ghandour and Ms. Lola Blackledge for preparation of the manuscript, and we greatly appreciate the staff of Bio-medical Image Processing Laboratory who were always helpful in the use of their facilities.
PY - 2001
Y1 - 2001
N2 - Background. The number of cells in glomeruli has been a challenging measure, especially in human kidneys, with only a small amount of tissue obtained by biopsy. However, the number of cells and their function are important determinants of renal function in health and disease. Methods. Modern morphometric techniques have now provided the means to determine the numerical density (Nv) and number (with a measure of glomerular volume) of endothelial cells, mesangial cells, and podocytes in plastic-embedded renal tissue biopsied from nondiabetic subjects (N = 36) and type 1 diabetic patients (N = 46) over an extended age range from childhood through late adult. Results. Nv values for all glomerular cells varied only slightly with age and did not change within the range of glomerular lesions of diabetes studied. Thus, the increase in glomerular volume during childhood to a steady level thereafter was the primary determinant of total glomerular cell number. The number of mesangial cells and endothelial cells increased with age, reflecting the increase in all cells, while the podocytes remained unchanged in number over all ages studied (10 to 69 years). Numbers of total glomerular cells, mesangial cells, and endothelial cells were not changed with diabetes, while podocytes were fewer in number in diabetic patients of all ages, with reduced podocyte numbers even in diabetes of short duration. Conclusions. The essentially constant glomerular cell density in nondiabetic and diabetic subjects under different circumstances possibly indicates an underlying propensity for the glomerulus to regulate its architecture to maintain a constant number of cells per volume, no matter the size of the glomerulus or the severity of diabetic nephropathy studied in this set of patients. The reductions in podocyte numbers in both younger and older diabetic patients indicate a significant risk for functional abnormalities as diabetic nephropathy progresses. Moreover, these observations do not support the suggestion of marked increases in glomerular cell number (and especially mesangial cells) with the development and progression of diabetic nephropathy.
AB - Background. The number of cells in glomeruli has been a challenging measure, especially in human kidneys, with only a small amount of tissue obtained by biopsy. However, the number of cells and their function are important determinants of renal function in health and disease. Methods. Modern morphometric techniques have now provided the means to determine the numerical density (Nv) and number (with a measure of glomerular volume) of endothelial cells, mesangial cells, and podocytes in plastic-embedded renal tissue biopsied from nondiabetic subjects (N = 36) and type 1 diabetic patients (N = 46) over an extended age range from childhood through late adult. Results. Nv values for all glomerular cells varied only slightly with age and did not change within the range of glomerular lesions of diabetes studied. Thus, the increase in glomerular volume during childhood to a steady level thereafter was the primary determinant of total glomerular cell number. The number of mesangial cells and endothelial cells increased with age, reflecting the increase in all cells, while the podocytes remained unchanged in number over all ages studied (10 to 69 years). Numbers of total glomerular cells, mesangial cells, and endothelial cells were not changed with diabetes, while podocytes were fewer in number in diabetic patients of all ages, with reduced podocyte numbers even in diabetes of short duration. Conclusions. The essentially constant glomerular cell density in nondiabetic and diabetic subjects under different circumstances possibly indicates an underlying propensity for the glomerulus to regulate its architecture to maintain a constant number of cells per volume, no matter the size of the glomerulus or the severity of diabetic nephropathy studied in this set of patients. The reductions in podocyte numbers in both younger and older diabetic patients indicate a significant risk for functional abnormalities as diabetic nephropathy progresses. Moreover, these observations do not support the suggestion of marked increases in glomerular cell number (and especially mesangial cells) with the development and progression of diabetic nephropathy.
KW - Cell density
KW - Diabetic nephropathy
KW - Morphometry
KW - Podocytes
KW - Progressive renal disease
KW - Renal function
KW - Urine volume
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U2 - 10.1046/j.1523-1755.2001.0590062104.x
DO - 10.1046/j.1523-1755.2001.0590062104.x
M3 - Article
C2 - 11380812
AN - SCOPUS:0035008793
SN - 0085-2538
VL - 59
SP - 2104
EP - 2113
JO - Kidney international
JF - Kidney international
IS - 6
ER -