In-vivo techniques for determining nephron number

Aleksandar Denic, Hisham Elsherbiny, Andrew D. Rule

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose of reviewMany studies have suggested low nephron endowment at birth contributes to the risk of developing hypertension and chronic kidney disease (CKD) later in life. Loss of nephrons with age and disease is largely a subclinical process. New technologies are needed to count nephrons as glomerular filtration rate (GFR) is a poor surrogate for nephron number.Recent findingsCortical volume, glomerular density, and percent globally sclerotic glomeruli are imperfect surrogates for nephron number. The disector-fractionator method is the most accurate method to count nephrons but is limited to autopsy settings. Glomerular density combined with kidney imaging and ultrafiltration coefficient-based methods require a kidney biopsy, and have been applied in living humans (kidney donors). Low nephron number predicts a higher postdonation urine albumin. Contrast-enhanced MRI has detected glomeruli without a biopsy, but so far, not in living humans.SummaryCurrently, there is no accurate and well tolerated method for determining nephron number in living humans. A clinically useful method may allow GFR to be replaced by its more relevant determinants: nephron number and single nephron GFR. This could revolutionize nephrology by separating the measurement of chronic disease (nephron loss) from more reversible hemodynamic effects (nephron hyperfiltration/hypofiltration).

Original languageEnglish (US)
Pages (from-to)545-551
Number of pages7
JournalCurrent opinion in nephrology and hypertension
Issue number6
StatePublished - Nov 1 2019


  • MRI
  • glomerular density
  • glomeruli
  • kidney biopsy
  • kidney volume
  • nephron number

ASJC Scopus subject areas

  • Internal Medicine
  • Nephrology


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