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Previous Volume 348:101-108 January 9, 2003 Number 2 Next

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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.

Source Information

From the Departments of Pathology (G.K.), Forensic Medicine (G.K., G.Z.), and Internal Medicine (E.R.), University of Heidelberg, Heidelberg; the Department of Pathology, City Hospital of Darmstadt, Darmstadt (G.M.); and the Department of Pathology, University of Erlangen-Nürnberg, Erlangen (K.A.) — all in Germany.

Address reprint requests to Dr. Amann at the Department of Pathology, University of Erlangen-Nürnberg, Krankenhausstr. 8-10, 91054 Erlangen, Germany, or at kerstin.amann{at}patho.imed.uni-erlangen.de.

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Nephron Number and Primary Hypertension
Johnson R. J., Rodríguez-Iturbe B., Herrera-Acosta J., O'Neill W. C., Querfeld U., Niaudet P., Amann K., Ritz E.
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N Engl J Med 2003; 348:1717-1719, Apr 24, 2003. Correspondence

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