| Project/Area Number |
19K08355
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52050:Embryonic medicine and pediatrics-related
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
Hirano Daishi 東京慈恵会医科大学, 医学部, 講師 (90424663)
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| Co-Investigator(Kenkyū-buntansha) |
神崎 剛 東京慈恵会医科大学, 医学部, 助教 (00816473)
湯坐 有希 地方独立行政法人東京都立病院機構東京都立小児総合医療センター(臨床研究部), その他, 部長 (30277090)
西崎 直人 順天堂大学, 医学部, 先任准教授 (30561435)
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Project Status |
Completed (Fiscal Year 2023)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | ネフロン数 / 小児 / 慢性腎臓病 / 腎予備能 / stereology |
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| Outline of Research at the Start |
本研究の目的は，小児の生体腎の総ネフロン数を推算し，ヒトの潜在的な腎予備能の差を明らかにすることによって将来の腎不全の進行や透析導入を遅らせることである．本研究によりネフロン数を決定する因子 (遺伝的要因，体格差，および低出生体重などの母体環境要因など) を明らかにすることできれば，腎障害の早期発見・治療介入が可能となり，ひいては将来の腎不全の進行や透析導入を遅らせることが可能となる．その結果，医療費の30分の1 (年間約1兆円) を占める透析医療費の一部を削減することが可能となる．
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| Outline of Final Research Achievements |
We examined pediatric patients with unilateral renal tumors undergoing nephrectomy. Stereological assessments of the areas of the cross-sections and cortex were performed to determine the volume and density of nonsclerotic glomeruli. Glomerular density was measured on high-resolution digital images of scanned specimens stained with PAS and HE, and measurement of the cortical and glomerular areas. The number and area of the glomeruli were measured. Kidneys from 21 children were examined. The estimated number of nephrons was significantly higher than reported for adult patients. The median number of glomeruli measured per patient was 64 (IQR, 60-78), and the median total number of nephrons per kidney was 950846 (IQR, 868760-1049293). This is one of the first studies to estimate the number of nephrons in the kidneys of living children. We contend that our results will provide a foundation for accurately determining the intrinsic renal reserve capacity.
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| Academic Significance and Societal Importance of the Research Achievements |
加齢に伴うネフロンの消失の影響を除外できる小児例を対象とした総ネフロン数の計測の意義は非常に大きいと考えられる。今後はさらに症例数を増やし、ネフロン数決定因子の探索、腎機能障害や将来的な腎予後評価について検討したい。
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