title: Detection and Clinical Patterns of Nephron Hypertrophy and Nephrosclerosis Among Apparently Healthy Adults.
abstract: BACKGROUND
  Even among ostensibly healthy adults, there is often mild pathology in the kidney. The detection of kidney microstructural variation and pathology by imaging and the clinical pattern associated with these structural findings is unclear.
  
  
  METHODS
  Cross-sectional (clinical-pathologic correlation).
  
  
  METHODS
  Living kidney donors at Mayo Clinic (Minnesota and Arizona sites) and Cleveland Clinic 2000 to 2011.
  
  
  METHODS
  Predonation kidney function, risk factors, and contrast computed tomographic scan of the kidneys. These scans were segmented for cortical volume and medullary volume, reviewed for parenchymal cysts, and scored for kidney surface roughness.
  
  
  RESULTS
  Nephrosclerosis (glomerulosclerosis, interstitial fibrosis/tubular atrophy, and arteriosclerosis) and nephron size (glomerular volume, mean profile tubular area, and cortical volume per glomerulus) determined from an implantation biopsy of the kidney cortex at donation.
  
  
  RESULTS
  Among 1,520 living kidney donors, nephrosclerosis associated with increased kidney surface roughness, cysts, and smaller cortical to medullary volume ratio. Larger nephron size (nephron hypertrophy) associated with larger cortical volume. Nephron hypertrophy and larger cortical volume associated with higher systolic blood pressure, glomerular filtration rate, and urine albumin excretion; larger body mass index; higher serum uric acid level; and family history of end-stage renal disease. Both nephron hypertrophy and nephrosclerosis associated with older age and mild hypertension. The net effect of both nephron hypertrophy and nephrosclerosis associating with cortical volume was that nephron hypertrophy diminished volume loss with age-related nephrosclerosis and fully negated volume loss with mild hypertension-related nephrosclerosis.
  
  
  CONCLUSIONS
  Kidney donors are selected on health, restricting the spectrum of pathologic findings. Kidney biopsies in living donors are a small tissue sample leading to imprecise estimates of structural findings.
  
  
  CONCLUSIONS
  Among apparently healthy adults, the microstructural findings of nephron hypertrophy and nephrosclerosis differ in their associations with kidney function, macrostructure, and risk factors.
authors: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
authors: Aleksandar
authors: A
authors: Denic
authors: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
authors: Mariam P
authors: MP
authors: Alexander
authors: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
authors: Vidhu
authors: V
authors: Kaushik
authors: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
authors: Lilach O
authors: LO
authors: Lerman
authors: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
authors: John C
authors: JC
authors: Lieske
authors: Division of Transplant Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Mark D
authors: MD
authors: Stegall
authors: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors: Joseph J
authors: JJ
authors: Larson
authors: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors: Walter K
authors: WK
authors: Kremers
authors: Department of Radiology, Mayo Clinic, Rochester, Minnesota.
authors: Terri J
authors: TJ
authors: Vrtiska
authors: Division of Nephrology and Hypertension, Mayo Clinic, Arizona.
authors: Harini A
authors: HA
authors: Chakkera
authors: Department of Nephrology, Cleveland Clinic, Cleveland, Ohio.
authors: Emilio D
authors: ED
authors: Poggio
authors: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
authors: Andrew D
authors: AD
authors: Rule
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis; D008297:Male; D009399:Nephrons / Q000473:pathology*; D009400:Nephrosclerosis / Q000175:diagnosis*
keywords: Nephrosclerosis; aging; arteriosclerosis; biopsy; chronic kidney disease (CKD) risk factor; contrast computed tomographic (CT) scan; high-resolution imaging; hypertension; kidney function; kidney macrostructure; kidney microstructure; kidney volume; living kidney donor; nephron hypertrophy; subclinical renal pathology