Nephron number in patients with primary hypertension

N Engl J Med. 2003 Jan 9;348(2):101-8. doi: 10.1056/NEJMoa020549.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Cell Count
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / pathology*
  • Hypertrophy, Left Ventricular / complications
  • Hypertrophy, Left Ventricular / pathology
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Kidney Glomerulus / anatomy & histology*
  • Kidney Glomerulus / cytology
  • Kidney Glomerulus / pathology
  • Male
  • Middle Aged
  • Nephrons / anatomy & histology
  • Organ Size
  • Reference Values