• Gunhild Keller, Gisela Zimmer, Gerhard Mall, Eberhard Ritz, and Kerstin Amann.
• Department of Pathology, University of Heidelberg, Heidelberg, Germany.
• N. Engl. J. Med. 2003 Jan 9; 348 (2): 101-8.

BackgroundA diminished number of nephrons has been proposed as one of the factors contributing to the development of primary hypertension.MethodsTo 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.ResultsPatients 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.ConclusionsThe data support the hypothesis that the number of nephrons is reduced in white patients with primary hypertension.Copyright 2003 Massachusetts Medical Society

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