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1/ Weekly neo-nephrology thread
#SoMe #MedTwitter #nephrology #tweetorial
@ASPNeph @ASNKidney
Neonatal glomerular filtration rate (GFR) is affected by:
1. Gestational age (GA)
2. Hemodynamic stability
3. Perinatal course
GA affects absolute renal mass or total kidney volume.
#SoMe #MedTwitter #nephrology #tweetorial
@ASPNeph @ASNKidney
Neonatal glomerular filtration rate (GFR) is affected by:
1. Gestational age (GA)
2. Hemodynamic stability
3. Perinatal course
GA affects absolute renal mass or total kidney volume.
2/ #SoMe #tweetiatrician #tweetorial
Why is GA so important?
Nephrogenesis starts week 5 of fetal life, however 60% of nephrons are formed in the third trimester. Preterm infants born before 36 weeks GA are in active nephrogenesis which’s vulnerable to extra-uterine factors.
Why is GA so important?
Nephrogenesis starts week 5 of fetal life, however 60% of nephrons are formed in the third trimester. Preterm infants born before 36 weeks GA are in active nephrogenesis which’s vulnerable to extra-uterine factors.
3/ #SoMe
Implications of ex-utero nephrogenesis:
1. First 4-6 postnatal weeks determine lifelong nephron endowment
2. Exposure to nephrotoxins & renal hypoperfusion affect future nephron number
3. Glomeruli formed ex-utero are often abnormal, cystic &/or atubular
Implications of ex-utero nephrogenesis:
1. First 4-6 postnatal weeks determine lifelong nephron endowment
2. Exposure to nephrotoxins & renal hypoperfusion affect future nephron number
3. Glomeruli formed ex-utero are often abnormal, cystic &/or atubular
4/
Nephron number could be estimated by:
1. Radial glomerular count of nephron generations
2. Gold standard is dissector method
3. Cationic ferritin injection followed by MRI is under research
Nephron number varies per individuals. Range: 200,000-2000,000 nephrons per kidney!
Nephron number could be estimated by:
1. Radial glomerular count of nephron generations
2. Gold standard is dissector method
3. Cationic ferritin injection followed by MRI is under research
Nephron number varies per individuals. Range: 200,000-2000,000 nephrons per kidney!
5/
Low nephron number is associated with risk of hypertension & CV diseases. Nephron number is proportionate to kidney size across all ages. Females have lower kidney size.
Aging results in glomerulosclerosis & decline in GFR by 10 ml every decade after 40 yrs old.
Low nephron number is associated with risk of hypertension & CV diseases. Nephron number is proportionate to kidney size across all ages. Females have lower kidney size.
Aging results in glomerulosclerosis & decline in GFR by 10 ml every decade after 40 yrs old.
6/
This’s so important when you start with a low nephron #.
Preterm babies who were born before 34 weeks GA, SGA & who had severe perinatal course are at risk of progressive CKD due to low nephron number, abnormal nephrogenesis & adverse events like hypotension, AKI, etc
This’s so important when you start with a low nephron #.
Preterm babies who were born before 34 weeks GA, SGA & who had severe perinatal course are at risk of progressive CKD due to low nephron number, abnormal nephrogenesis & adverse events like hypotension, AKI, etc
7/ #tweetorial #SoMe
Lastly: which organs develop by branching organogenesis?
Kidney, lung, pancreas & vasculature. Hence due to incomplete in utero formation long term complications of preterm birth include: CKD, chronic lung disease, vascular accidents & insulin resistance.
Lastly: which organs develop by branching organogenesis?
Kidney, lung, pancreas & vasculature. Hence due to incomplete in utero formation long term complications of preterm birth include: CKD, chronic lung disease, vascular accidents & insulin resistance.
