Kidney medicine · 2026
Associations of Nephron Number, Birth Weight, and Causes of Death in a Community at High Risk of Hypertension and Cardiovascular Disease.
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Hughson Michael D, Douglas-Denton Rebecca N, Hoy Wendy E, Winkler Cheryl A, Kopp Jeffrey B, Bertram John F
Аннотация
RATIONALE & OBJECTIVE: Low birth weight (LBW) and low nephron number may increase the risk of hypertension and cardiovascular disease (CVD).
STUDY DESIGN: Total glomerular number was determined by stereological analysis of autopsy kidneys from 336 participants. Health Department-recorded birth weights were obtained for 204 participants who were ≤55 years old.
OUTCOMES: Birth weight, nephron number.
PREDICTORS: Hypertension, CVD, age, biological sex, body mass index, poverty index, and APOL1 genotype.
ANALYTICAL APPROACH: Relationships were investigated using group comparisons and regression models.
SETTINGS & PARTICIPANTS: Performance sites: Autopsies, University Medical Center, Jackson, MS; Stereology, Department of Anatomy and Developmental Biology, Monash University, Melbourne; APOL1 genotyping, Basic Research Laboratory, Center for Cancer Research, National Institutes of Health, Frederick, Maryland.
RESULTS: In total, 170 participants having birth weights were adults, 29% of adults were hypertensive, and 40% died of CVD. Genotyping identified 22 Black participants with 2 APOL1 risk alleles. A median of 718,409 glomeruli per kidney was found for participants with LBW (< 2.5 kg), which was significantly less than the median of 936,937 glomeruli found with birth weights from 3.0 to 4.0 kg (P < 0.001). Among adults ≤ 55 years old, hypertension correlated with age (P < 0.001) and the severity of glomerulosclerosis (P < 0.001), and CVD death correlated with hypertension (P = 0.01). However, neither LBW nor nephron number was associated with hypertension or CVD death or with an APLO1 high-risk genotype. Among participants aged 65-89 years, increased glomerulosclerosis was associated with a lower median glomerular number (759,623; P = 0.02) and with hypertension (P < 0.01).
LIMITATIONS: Relationships of predictors to outcomes are abridged by death at recruitment.
CONCLUSIONS: LBW and low nephron number were not related to hypertension or CVD in adults ≤ 55 years of age, but a glomerulosclerosis-related reduction in glomerular number may contribute to hypertension and CVD in later life.
STUDY DESIGN: Total glomerular number was determined by stereological analysis of autopsy kidneys from 336 participants. Health Department-recorded birth weights were obtained for 204 participants who were ≤55 years old.
OUTCOMES: Birth weight, nephron number.
PREDICTORS: Hypertension, CVD, age, biological sex, body mass index, poverty index, and APOL1 genotype.
ANALYTICAL APPROACH: Relationships were investigated using group comparisons and regression models.
SETTINGS & PARTICIPANTS: Performance sites: Autopsies, University Medical Center, Jackson, MS; Stereology, Department of Anatomy and Developmental Biology, Monash University, Melbourne; APOL1 genotyping, Basic Research Laboratory, Center for Cancer Research, National Institutes of Health, Frederick, Maryland.
RESULTS: In total, 170 participants having birth weights were adults, 29% of adults were hypertensive, and 40% died of CVD. Genotyping identified 22 Black participants with 2 APOL1 risk alleles. A median of 718,409 glomeruli per kidney was found for participants with LBW (< 2.5 kg), which was significantly less than the median of 936,937 glomeruli found with birth weights from 3.0 to 4.0 kg (P < 0.001). Among adults ≤ 55 years old, hypertension correlated with age (P < 0.001) and the severity of glomerulosclerosis (P < 0.001), and CVD death correlated with hypertension (P = 0.01). However, neither LBW nor nephron number was associated with hypertension or CVD death or with an APLO1 high-risk genotype. Among participants aged 65-89 years, increased glomerulosclerosis was associated with a lower median glomerular number (759,623; P = 0.02) and with hypertension (P < 0.01).
LIMITATIONS: Relationships of predictors to outcomes are abridged by death at recruitment.
CONCLUSIONS: LBW and low nephron number were not related to hypertension or CVD in adults ≤ 55 years of age, but a glomerulosclerosis-related reduction in glomerular number may contribute to hypertension and CVD in later life.