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Peer-reviewedCC BY 4.0International Journal of Molecular Sciences

Low Nephron Number and Kidney Disease

  1. 1Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA

Abstract

Reduced nephron endowment and acquired nephron loss increase susceptibility to hypertension and chronic kidney disease (CKD). Low birth weight, prematurity, genetic factors, and adverse prenatal exposures can limit nephron development, whereas aging and kidney injury reduce the number of functioning nephrons after birth. Compensatory glomerular hypertrophy and increased single-nephron filtration can initially preserve overall glomerular filtration rate, but sustained glomerular stress may promote podocyte injury, proteinuria, and glomerulosclerosis. These changes can accelerate nephron loss and create a cycle of progressive kidney damage. Disease susceptibility depends on genetic background and additional metabolic, environmental, and hemodynamic stresses. This review examines the determinants of nephron number, the adaptive and potentially harmful consequences of nephron reduction, and approaches to preserving kidney function. Improving maternal health, reducing harmful exposures, and controlling hypertension and metabolic disease may reduce the long-term consequences of low nephron number.

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BibTeX
@article{goorani2026nephron,
  title = {{Low Nephron Number and Kidney Disease}},
  author = {Samaneh Goorani and John D. Imig},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = oct,
  doi = {10.3390/ijms27198888},
  url = {https://www.mdpi.com/1422-0067/27/19/8888},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Low Nephron Number and Kidney Disease
AU  - Samaneh Goorani
AU  - John D. Imig
PY  - 2026
DA  - 2026/10/07
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27198888
UR  - https://www.mdpi.com/1422-0067/27/19/8888
AB  - Reduced nephron endowment and acquired nephron loss increase susceptibility to hypertension and chronic kidney disease (CKD). Low birth weight, prematurity, genetic factors, and adverse prenatal exposures can limit nephron development, whereas aging and kidney injury reduce the number of functioning nephrons after birth. Compensatory glomerular hypertrophy and increased single-nephron filtration can initially preserve overall glomerular filtration rate, but sustained glomerular stress may promote podocyte injury, proteinuria, and glomerulosclerosis. These changes can accelerate nephron loss and create a cycle of progressive kidney damage. Disease susceptibility depends on genetic background and additional metabolic, environmental, and hemodynamic stresses. This review examines the determinants of nephron number, the adaptive and potentially harmful consequences of nephron reduction, and approaches to preserving kidney function. Improving maternal health, reducing harmful exposures, and controlling hypertension and metabolic disease may reduce the long-term consequences of low nephron number.
SN  - 1422-0067
ER  -