Case report: increased single-nephron estimated glomerular filtration rate in an adult patient with low birth weight

BMC Nephrol. 2020 Mar 4;21(1):75. doi: 10.1186/s12882-020-01728-6.

Abstract

Background: Low birth weight (LBW) is associated with end-stage kidney disease and hypertension and is considered to be a surrogate marker of low nephron number. Low nephron number is hypothesized to contribute to glomerular hyperfiltration that may cause kidney injury; however, this is not yet proven. Until now, the hyperfiltration in LBW patients has not been shown directly yet.

Case presentation: A 23-years-old female was referred with the persistent proteinuria and decreased renal function (estimated glomerular filtration rate by cystatin C (eGFRcys); 41.86 ml/min). She was a premature baby with low birth weight (704 g, 24 gestational weeks). Renal biopsy demonstrated focal segmental glomerulosclerosis (FSGS) of the perihilar variant with expanded glomerular diameter. We calculated the single-nephron estimated glomerular filtration rate (SN-eGFR) that was higher than that of the same age group in the healthy living kidney donors and speculated that glomerular hyperfiltration is a pathophysiological cause of FSGS.

Conclusion: This is the first case of SN-eGFR measurement in a patient with LBW. The increased SN-eGFR in this case provides an important insight into the pathophysiological mechanisms of LBW for its progression to kidney disease.

Keywords: Glomerular hyperfiltration; Low birth weight; Single-nephron estimated glomerular filtration rate.

Publication types

  • Case Reports

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Cell Count
  • Female
  • Glomerular Filtration Rate*
  • Glomerulosclerosis, Focal Segmental / diagnosis
  • Glomerulosclerosis, Focal Segmental / drug therapy
  • Glomerulosclerosis, Focal Segmental / pathology*
  • Glomerulosclerosis, Focal Segmental / physiopathology*
  • Humans
  • Infant, Low Birth Weight*
  • Losartan / therapeutic use
  • Nephrons / pathology*
  • Proteinuria
  • Young Adult

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Losartan