Low Birthweight and Premature Birth Are Risk Factors for Podocytopenia and Focal Segmental Glomerulosclerosis
Low Birthweight and Premature Birth Are Risk Factors for Podocytopenia and Focal Segmental Glomerulosclerosis
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DOI：
10.1159/000353898
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发表时间：
2013-01-01
影响因子：
4.2
通讯作者：
Uchiyama, Makoto
中科院分区：
文献类型：
--
作者：
Ikezumi, Yohei;Suzuki, Toshiaki;Uchiyama, Makoto
背景资料：最近的报告表明，低出生体重（LBW）是肾脏疾病，包括局灶节段性肾小球硬化症（FSGS）的危险因素，但其潜在的病理机制仍不清楚。足细胞丢失触发肾小球硬化;然而，LBW儿童的FSGS是否与足细胞减少症相关尚不清楚。方法：我们回顾了1995年至2011年在我们研究所接受肾活检的所有患者的出生体重和胎龄。16例患者患有FSGS，其中6例（37.5%）患有LBW;该LBW率显著高于日本的总体LBW率（9.7%）。微小病变型肾病综合征（MCNS; 12.5%）患者LBW的发生率也较高。采用计算机图像分析技术计算活检切片中肾小球细胞数，并与正常出生体重FSGS（NBW-FSGS）进行比较。还比较了年龄匹配的MCNS患者的活检标本。进行Wilms' tumor-1（WT 1）免疫组织化学以计数足细胞。结果：LBW-FSGS组的所有患者均为早产，平均胎龄为25.8周。LBW-FSGS患者中每个肾小球的足细胞数分别比MCNS患者（p < 0.01）和NBW-FSGS患者（p < 0.05）低34和24%。WT 1阳性肾小球细胞数也观察到类似的结果。结论：LBW和早产与FSGS的发生有关。低出生体重和早产可能是FSGS患儿严重足细胞减少症的易感因素，值得进一步研究。版权所有（C）2013 S. Karger AG，巴塞尔
Background: Recent reports suggest that low birthweight (LBW) is a risk factor for kidney diseases, including focal segmental glomerulosclerosis (FSGS), although the underlying pathological mechanism remains unknown. Podocyte loss triggers glomerulosclerosis; however, whether FSGS in LBW children is associated with podocytopenia is unclear. Methods:We reviewed the birthweights and gestational age of all patients who underwent renal biopsies from 1995 to 2011 at our Institute. Sixteen patients had FSGS, of which 6 (37.5%) had LBW; this LBW rate was significantly higher than the overall LBW rate in Japan (9.7%). The incidence of LBW was also high in patients with minimal change nephrotic syndrome (MCNS; 12.5%). The glomerular cell numbers in biopsy sections were calculated using computer image analysis and compared with FSGS of normal birthweight (NBW-FSGS). Biopsy specimens from age-matched patients with MCNS were also compared. Wilms' tumor-1 (WT1) immunohistochemistry was performed to enumerate the podocytes. Results: All patients in the LBW-FSGS group were also preterm, with an average gestational age of 25.8 weeks. The number of podocytes per glomerulus in the LBW-FSGS patients was 34 and 24% lower as compared to that in the MCNS patients (p < 0.01) and the NBW-FSGS patients (p < 0.05), respectively. Similar results were observed for the WT1-positive glomerular cell number. Conclusion: LBW and premature birth were associated with FSGS development. The possibility that LBW and premature birth may be predisposing factors for severe podocytopenia in children with FSGS warrants further investigation. Copyright (C) 2013 S. Karger AG, Basel