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Lin MH, Chen JC, Tian X, Lee CM, Yu IS, Lo YF, Uchida S, Huang CL, Chen BC, Cheng CJ. Impairment in renal medulla development underlies salt wasting in Clc-k2 channel deficiency. JCI Insight 2021; 6:e151039. [PMID: 34499620 PMCID: PMC8564913 DOI: 10.1172/jci.insight.151039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022] Open
Abstract
The prevailing view is that the ClC-Ka chloride channel (mouse Clc-k1) functions in the thin ascending limb to control urine concentration, whereas the ClC-Kb channel (mouse Clc-k2) functions in the thick ascending limb (TAL) to control salt reabsorption. Mutations of ClC-Kb cause classic Bartter syndrome, characterized by renal salt wasting, with perinatal to adolescent onset. We studied the roles of Clc-k channels in perinatal mouse kidneys using constitutive or inducible kidney-specific gene ablation and 2D and advanced 3D imaging of optically cleared kidneys. We show that Clc-k1 and Clc-k2 were broadly expressed and colocalized in perinatal kidneys. Deletion of Clc-k1 and Clc-k2 revealed that both participated in NKCC2- and NCC-mediated NaCl reabsorption in neonatal kidneys. Embryonic deletion of Clc-k2 caused tubular injury and impaired renal medulla and TAL development. Inducible deletion of Clc-k2 beginning after medulla maturation produced mild salt wasting resulting from reduced NCC activity. Thus, both Clc-k1 and Clc-k2 contributed to salt reabsorption in TAL and distal convoluted tubule (DCT) in neonates, potentially explaining the less-severe phenotypes in classic Bartter syndrome. As opposed to the current understanding that salt wasting in adult patients with Bartter syndrome is due to Clc-k2 deficiency in adult TAL, our results suggest that it originates mainly from defects occurring in the medulla and TAL during development.
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Affiliation(s)
- Meng-Hsuan Lin
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, and.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Jen-Chi Chen
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, and
| | - Xuejiao Tian
- Brain Research Center, National Tsing Hua University, Hsinchu, Taiwan
| | - Chia-Ming Lee
- Research Center for Applied Sciences, Academia Sinica, Taipei, Taiwan
| | - I-Shing Yu
- Laboratory Animal Center, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Fen Lo
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, and
| | - Shinichi Uchida
- Department of Nephrology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chou-Long Huang
- Division of Nephrology, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Bi-Chang Chen
- Brain Research Center, National Tsing Hua University, Hsinchu, Taiwan.,Research Center for Applied Sciences, Academia Sinica, Taipei, Taiwan
| | - Chih-Jen Cheng
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, and.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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2
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Coombs PR, Lavender I, Leung MYZ, Woods JC, Paul E, Webb N, Ditchfield M. Normal sonographic renal length measurements in an Australian pediatric population. Pediatr Radiol 2019; 49:1754-1761. [PMID: 31428797 DOI: 10.1007/s00247-019-04486-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/04/2019] [Accepted: 07/29/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reference charts depicting normal growth are important for the sonographic assessment of the pediatric kidney. Limited charts are available for clinical use in an Australian population. OBJECTIVE To retrospectively collate sonographic renal length measurements in a cohort of low-risk Australian children aged newborn to 16 years to produce a reference table and comparison with other published charts. MATERIALS AND METHODS We identified consecutive pediatric patients who were at low risk for renal disease and had renal lengths measured. After exclusions, we included 941 renal lengths (male 490, female 451). We used linear regression to estimate the relationship of renal length with age, gender and side. We calculated percentile values of renal length according to age categories. RESULTS No statistically significant differences in mean renal length were observed between males and females, or for left and right kidneys. We tabulated reference data and provide them in a reference chart (1-, 2.5-, 5-, 10-, 50-, 90-, 97.5- and 99-percentiles). CONCLUSION We calculated new reference ranges for pediatric renal length using a larger cohort than previously published, from a population with diverse ethnicity.
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Affiliation(s)
- Peter R Coombs
- Ultrasound, Monash Imaging, Monash Children's Hospital, Monash Health, 246 Clayton Road, Clayton, 3168, Australia.
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Australia.
| | - Ilona Lavender
- Ultrasound, Monash Imaging, Monash Children's Hospital, Monash Health, 246 Clayton Road, Clayton, 3168, Australia
| | - Michelle Y Z Leung
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Australia
| | - Jessica C Woods
- Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Monash University, Clayton, Australia
| | - Eldho Paul
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Nathalie Webb
- Department of Paediatric Urology, Monash Children's Hospital, Monash Health, Clayton, Australia
| | - Michael Ditchfield
- Ultrasound, Monash Imaging, Monash Children's Hospital, Monash Health, 246 Clayton Road, Clayton, 3168, Australia
- Department of Paediatrics and Department of Diagnostic Imaging, Monash University, Clayton, Australia
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3
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Chaara H, Adadi H, Attar I, Jayi S, Alaoui FZF, Melhouf MA. [Prenatal diagnosis of multicystic dysplastic kidney: about 18 cases]. Pan Afr Med J 2019; 33:279. [PMID: 31692819 PMCID: PMC6815520 DOI: 10.11604/pamj.2019.33.279.18485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/10/2019] [Indexed: 11/11/2022] Open
Abstract
Multicystic dysplastic kidney (MCDK) is the most common Congenital Abnormalities of Kidney and Urinary Tract (CAKUT) in clinical practice. Its etiology and pathogenesis are still controversial and obstruction is a generally accepted causative assumption. Obstetric ultrasound is the gold standard for prenatal diagnosis and for the detection of other associated malformations. Prenatal management is based on ultrasound monitoring of pregnancy, of the disease, of the occurrence of other anomalies and of the amount of amniotic fluid. This study aims to report our experience in the Department of Gynecology-Obstetrics 2 at the University Hospital Hassan II-Fez in order to clarify the epidemiology of MCDK, highlight the role of obstetric ultrasound in positive and etiological diagnosis while describing the various sonographic appearances. It is essential to schedule for screening tests during pregnancy in order to assess the evolution of the disease diagnosed in the prenatal period, to implement a strategy in postpartum care and to establish a prognosis.
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Affiliation(s)
- Hekmat Chaara
- Service Gynécologie Obstétrique II, CHU Hassan II, Fès, Maroc
| | - Hind Adadi
- Service Gynécologie Obstétrique II, CHU Hassan II, Fès, Maroc
| | - Imane Attar
- Service Gynécologie Obstétrique II, CHU Hassan II, Fès, Maroc
| | - Sofia Jayi
- Service Gynécologie Obstétrique II, CHU Hassan II, Fès, Maroc
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4
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Duminda WD, Pathirana KG, Fernando MUJ, Samarasinghe RANKK, Ananda WDHA, Silva KSP, Dissanayake CK, Mahesh PKB. Ultrasonographic length of morphologically-normal kidneys in children presented to a premier tertiary healthcare setting of Sri Lanka. BMC Nephrol 2019; 20:183. [PMID: 31117988 PMCID: PMC6532158 DOI: 10.1186/s12882-019-1377-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 05/08/2019] [Indexed: 11/23/2022] Open
Abstract
Background Accurate prediction of reference ranges of renal lengths facilitates clinical decision making. Currently a single renal-length-reference chart is used for both kidneys, which is solely based on the age of the child without adjusting for anthropometrics. Objective of the study is to assess the length of morphologically-normal kidneys ultrasonically and to build models to predict the renal lengths of children presenting at the Radiology Department of Lady Ridgeway Hospital for Children. Methods A descriptive cross sectional study was done among 424 children with 233 males and 191 females at the study setting. Study population included children undergoing abdominal ultrasound scans for indications not related to renal disease. Children with a family history of renal diseases or with morphologically-abnormal kidneys were excluded. Bipolar-lengths of kidneys, gender and anthropometrics were documented. Having tested for assumptions, Wilcoxon-signed rank test, Mann-Whitney U test and multiple linear regression were used. Results The mean (SD) bipor-length of right and left kidneys were 6.83 (1.43) and 7.05 (1.36) respectively (p < 0.001). Age, height and weight were significantly correlated with the renal lengths (p < 0.05). Until 16 months, there was a significant difference between the renal lengths between males and females (P < 0.05). Yet the association with gender was not significant from 17 months and in overall. Until 16 months, the best linear-regression equation (p < 0.001) for the left kidney was; 3.827 + 0.019(length in centimeters) + 0.141(weight in kilograms) - 0.023(age in months) - 0.347(for male sex). For the right kidney, it was; 3.888 + 0.020(length or height) + 0.121(weight) - 0.037(age) - 0.372 (for male sex). The respective R squares were 59.2 and 53.5% with VIF (Variance-Inflation-Factor) ranging from 1.06 to 2.08. From 17 months, best equation for left kidney (p < 0.001) was; 5.651+ 0.022(age) + 0.01(BMI). For right kidney it was; 5.336 + 0.022(age) + 0.012(BMI). The R squares were 62.5 and 66.1% with VIF being 1. Conclusions The established models explain more variability for children above 17 months. Both renal lengths are affected significant by the body’s’ anthropometric parameters. For each kidney, separate normograms of renal lengths which are local-context-specific must be prepared. Further research must be promoted. Electronic supplementary material The online version of this article (10.1186/s12882-019-1377-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- W D Duminda
- Post Graduate Institute of Medicine, Colombo, Sri Lanka.
| | - K G Pathirana
- Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | | | | | | | - K S P Silva
- Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | | | - P K B Mahesh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Ministry of Health, Colombo, Sri Lanka
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Oh MS, Hwang G, Han S, Kang HS, Kim SH, Kim YD, Kang KS, Shin KS, Lee MS, Choi GM, Han KH. Sonographic Growth Charts for Kidney Length in Normal Korean Children: a Prospective Observational Study. J Korean Med Sci 2016; 31:1089-93. [PMID: 27366007 PMCID: PMC4901001 DOI: 10.3346/jkms.2016.31.7.1089] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/09/2016] [Indexed: 11/20/2022] Open
Abstract
Kidney length is the most useful parameter for clinical measurement of kidney size, and is useful to distinguish acute kidney injury from chronic kidney disease. In this prospective observational study of 437 normal children aged between 0 and < 13 years, kidney length was measured using sonography. There were good correlations between kidney length and somatic values, including age, weight, height, and body surface area. The rapid growth of height during the first 2 years of life was intimately associated with a similar increase in kidney length, suggesting that height should be considered an important factor correlating with kidney length. Based on our findings, the following regression equation for the reference values of bilateral kidney length for Korean children was obtained: kidney length of the right kidney (cm) = 0.051 × height (cm) + 2.102; kidney length of the left kidney (cm) = 0.051 × height (cm) + 2.280. This equation may aid in the diagnosis of various kidney disorders.
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Affiliation(s)
- Min-su Oh
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Geol Hwang
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Sanghoon Han
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Hyun Sik Kang
- Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
| | - Seung Hyo Kim
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Young Don Kim
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Ki-Soo Kang
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Kyung-Sue Shin
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Mu Sook Lee
- Department of Diagnostic Radiology, Jeju National University School of Medicine, Jeju, Korea
| | - Guk Myung Choi
- Department of Diagnostic Radiology, Jeju National University School of Medicine, Jeju, Korea
| | - Kyoung Hee Han
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
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6
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Affiliation(s)
- Robert L Chevalier
- Division of Pediatric Nephrology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
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7
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Lee MJ, Son MK, Kwak BO, Park HW, Chung S, Kim KS. Kidney size estimation in Korean children with Technesium-99m dimercaptosuccinic acid scintigraphy. KOREAN JOURNAL OF PEDIATRICS 2014; 57:41-5. [PMID: 24578716 PMCID: PMC3935112 DOI: 10.3345/kjp.2014.57.1.41] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 09/13/2013] [Accepted: 10/10/2013] [Indexed: 01/21/2023]
Abstract
PURPOSE Renal size is an important indicator to determine adequate organ growth in children. The aim of this study was to estimate renal size with Technesium-99m dimercaptosuccinic acid (DMSA) scan and propose a simple formula for predicting renal length in normal Korean children. METHODS This study included 346 children (148 boys and 198 girls; age range, 1 month to 17 years) in whom renal length was measured using the DMSA scan. Patients with anatomical renal abnormalities or acute pyelonephritis were excluded. Children were divided into two groups: 214 children (61.8%) were less than a year old (group 1) and 132 (38.2%) were ≥1 year (group 2). RESULTS Renal length was larger on the left side than the right side, and there was no significant gender-related difference in renal length. We propose the following formula for renal length based on the analysis of the 346 children in our study: the formula was as follows: 4.682×age (month)(0.137), R(2) =0.780. In group 1, the formula was renal length (cm)=0.127×age (month)+5.144, R(2) =0.354, and in group 2, the formula was 0.334×age (year)+6.477, R(2) =0.829. CONCLUSION It is difficult to establish simple formulae in infants (R(2) =0.354). Therefore, further studies including relevant variables are needed for this age group. We proposed formulae to estimate renal length in Korean children over 1 year of age by using the DMSA scan.
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Affiliation(s)
- Min Jung Lee
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Mi Kyung Son
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Byung Ok Kwak
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Hye Won Park
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Kyo Sun Kim
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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8
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Forbes MS, Thornhill BA, Galarreta CI, Minor JJ, Gordon KA, Chevalier RL. Chronic unilateral ureteral obstruction in the neonatal mouse delays maturation of both kidneys and leads to late formation of atubular glomeruli. Am J Physiol Renal Physiol 2013; 305:F1736-46. [PMID: 24107422 DOI: 10.1152/ajprenal.00152.2013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Unilateral ureteral obstruction (UUO) in the adult mouse is the most widely used model of progressive renal disease: the proximal tubule is the nephron segment most severely affected and atubular glomeruli are formed after only 7 days of UUO. To determine the proximal nephron response to UUO in the maturing kidney, neonatal mice were examined 7 to 28 days following complete UUO under general anesthesia. Proximal tubular mass and maturation were determined by staining with Lotus tetragolonobus lectin. Superoxide was localized by nitroblue tetrazolium and collagen by Sirius red. Cell proliferation, cell death, PAX-2, megalin, α-smooth muscle actin (α-SMA), renin, and fibronectin were identified by immunohistochemistry. During the first 14 days of ipsilateral UUO, despite oxidative stress (4-hydroxynonenal staining), glomerulotubular continuity was maintained and mitochondrial superoxide production persisted. However, from 14 to 28 days, papillary growth was impaired and proximal tubules collapsed with increased apoptosis, autophagy, mitochondrial loss, and formation of atubular glomeruli. Fibronectin, α-SMA, and collagen increased in the obstructed kidney. Oxidative stress was present also in the contralateral kidney: renin was decreased, glomerulotubular maturation and papillary growth were delayed, followed by increased cortical and medullary growth. We conclude that neonatal UUO initially delays renal maturation and results in oxidative stress in both kidneys. In contrast to the adult, proximal tubular injury in the neonatal obstructed kidney is delayed at 14 days, followed only later by the formation of atubular glomeruli. Antioxidant therapies directed at proximal tubular mitochondria during early renal maturation may slow progression of congenital obstructive nephropathy.
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Affiliation(s)
- Michael S Forbes
- Dept. of Pediatrics, Univ. of Virginia, Box 800386, Charlottesville, VA 22908.
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Giapros V, Tsoni C, Challa A, Cholevas V, Argyropoulou M, Papadopoulou F, Siomou E, Drougia A, Andronikou S. Renal function and kidney length in preterm infants with nephrocalcinosis: a longitudinal study. Pediatr Nephrol 2011; 26:1873-80. [PMID: 21533868 DOI: 10.1007/s00467-011-1895-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 03/31/2011] [Accepted: 04/11/2011] [Indexed: 10/18/2022]
Abstract
Renal injury in early life may lead to hypertension and renal disease in adulthood. In this prospective study, we estimated renal glomerular and tubular function and kidney length (KL) during the first 2 years of life of preterm infants with nephrocalcinosis (NC) associated with prematurity. The study cohort comprised 107 preterm children, 63 with NC and 44 control subjects without NC who were matched for gender, gestational age and birth weight. Kidney function was estimated based on measurements of serum creatinine (Scr), estimated glomerular filtration rate (eGFR), fractional excretion (FE) of sodium (Na), potassium (K), phosphate (P), magnesium (Mg) and uric acid (UA) and on the ratios of urinary Ca, oxalate (UOx) and citrate (UCit) to urinary creatinine (UCa/Ucr, UOx/Ucr and UCit/Ucr, respectively) calculated from morning urine collections. KL was measured by ultrasonography. Measurements were made at 40 weeks postmenstrual age and at 3, 6, 12 and 24 months of age. At 3 and 6 months, the NC group had higher UCa/Ucr, FEK and FEUA than the control group; at 12 months, only the UCa/Ucr and FEUA was still higher. The UCa/UCit ratio was higher in the NC group. Scr and eGFR did not differ between the groups at any time point. The NC group had a shorter KL up to 12 months of life (left kidney) or 24 months (right kidney). Based on these results, we conclude that NC in the preterm infants enrolled in our study was associated with impaired renal tubular function and a shorter KL in the first year of life.
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Affiliation(s)
- Vasileios Giapros
- Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece.
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10
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Yoo KH, Thornhill BA, Forbes MS, Chevalier RL. Compensatory renal growth due to neonatal ureteral obstruction: implications for clinical studies. Pediatr Nephrol 2006; 21:368-75. [PMID: 16382318 DOI: 10.1007/s00467-005-2119-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2005] [Revised: 08/29/2005] [Accepted: 08/29/2005] [Indexed: 10/25/2022]
Abstract
In response to unilateral ureteral obstruction (UUO), the contralateral kidney undergoes compensatory renal growth, which is enhanced in early development. We investigated the renal growth response to UUO in the neonatal rat. Within 2 days of birth, animals were subjected to sham-operation, complete UUO, or variable partial UUO, and kidneys were harvested 3-60 days later. Contralateral kidney weight increased after only 7 days of complete UUO. Increase in contralateral kidney weight was not significant for partial UUO until 45 days, but kidney/body weight ratio increased after only 14 days of 0.3 mm partial UUO. The rate of contralateral renal growth increased with age and with increasing severity of UUO. In rats subjected to 45 days UUO, glomerular area was proportional to kidney/body weight ratio (r =0.61, p <0.01). We conclude that the rate of compensatory renal growth is dependent on the severity and duration of obstruction, and takes place at the single nephron level. The results suggest that biologic variability limits the early detection of compensatory renal growth, which is compounded by limitations in measuring renal size by clinical imaging. Factoring kidney length (or volume) by intervertebral length (or body surface area) should improve the precision of tracking renal growth.
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Affiliation(s)
- Kee Hwan Yoo
- Department of Pediatrics, Korea University Guro Hospital, Seoul
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11
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Schmidt IM, Main KM, Damgaard IN, Mau C, Haavisto AM, Chellakooty M, Boisen KA, Petersen JH, Scheike T, Olgaard K. Kidney growth in 717 healthy children aged 0-18 months: a longitudinal cohort study. Pediatr Nephrol 2004; 19:992-1003. [PMID: 15206038 DOI: 10.1007/s00467-004-1479-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2003] [Revised: 03/09/2004] [Accepted: 03/09/2004] [Indexed: 12/23/2022]
Abstract
Kidney size is an important parameter in the evaluation of children with renal disease. However, reference materials for kidney size in healthy children have been limited beyond the neonatal period. We performed a longitudinal cohort study of 717 healthy children born at term with normal birth weight. Kidney size and shape were determined by ultrasonography and related to gender, age, and body size (weight, length, body surface area, skinfold thickness) at 0, 3, and 18 months of age. Gender-differentiated reference charts were established. Boys had significantly larger kidney volumes than girls ( P<0.001) and larger relative volumes (kidney volume/weight) at 0 and 3 months ( P<0.001), but not at 18 months of age. The best single predictor of gender-differentiated kidney volume was weight. Relative kidney volume changed with increasing age and height in a two-phase pattern: an initial decrease until a height of 65-70 cm was reached followed by a stable level. In conclusion, kidney size was significantly influenced by gender, age, and body composition. Relative kidney volume decreased with increasing age and height in a two-phase pattern. These characteristic changes in kidney volume indicated that infant kidney growth might be influenced by sex steroids and growth hormone in addition to body composition.
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Affiliation(s)
- Ida M Schmidt
- University Department of Growth and Reproduction, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark,
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