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Umbilical artery histomorphometry: a link between the intrauterine environment and kidney development

Published online by Cambridge University Press:  06 March 2017

M. J. DeFreitas*
Affiliation:
Pediatric Nephrology, School of Medicine, University of Miami, Miami, FL, USA
D. Mathur
Affiliation:
Pediatric Pathology, University of Miami, Miami, FL, USA
W. Seeherunvong
Affiliation:
Pediatric Nephrology, School of Medicine, University of Miami, Miami, FL, USA
T. Cano
Affiliation:
Pediatric Nephrology, School of Medicine, University of Miami, Miami, FL, USA
C. P. Katsoufis
Affiliation:
Pediatric Nephrology, School of Medicine, University of Miami, Miami, FL, USA
S. Duara
Affiliation:
Neonatology, University of Miami, Miami, FL, USA
S. Yasin
Affiliation:
Obstetrics/Gynecology, University of Miami, Miami, FL, USA
G. Zilleruelo
Affiliation:
Pediatric Nephrology, School of Medicine, University of Miami, Miami, FL, USA
M. M. Rodriguez
Affiliation:
Pediatric Pathology, University of Miami, Miami, FL, USA
C. L. Abitbol
Affiliation:
Pediatric Nephrology, School of Medicine, University of Miami, Miami, FL, USA
*
*Address for correspondence: M. J. DeFreitas, Pediatric Nephrology, School of Medicine, University of Miami, 1611 NW 12th Ave, Institute Annex, Suite 504, Miami, FL 33136-1015, USA. (Email mdefreitas@med.miami.edu)

Abstract

Prematurity is a risk factor for hypertension, vascular stiffness, nephron deficit and adult onset cardiorenal disease. The vascular tree and kidneys share morphogenic drivers that promote maturation in utero before 36 weeks of gestation. Vascular elastin accrual terminates after birth leaving collagen to promote vascular stiffness. Our objective was to determine if the histomorphometry of the umbilical artery, an extension of the aorta, parallels nephron mass across gestational age groups. From a cohort of 54 newborns, 32 umbilical cord specimens were adequate for evaluation. The umbilical cord was sectioned, stained with trichrome, and digitalized. Muscular and collagenous areas of the umbilical artery were measured in pixels using the Image J 1.48q software. Total kidney volume was measured by ultrasound and factored by body surface area (TKV/BSA). The umbilical artery total area was significantly greater in term v. preterm infants (9.3±1.3 v. 7.0±2.0 mm2; P<0.05) and increased with gestational age; while the percent muscular and collagen areas were independent of gestational age (R2=0.04; P=ns). Percent muscular area correlated positively with TKV/BSA (r=0.53; P=0.002); while an increase in collagen correlated inversely with kidney mass (r=−0.53; P=0.002). In conclusion, an enhanced % muscular area and presumed vascular elasticity was associated with increased renal mass in all infants. Umbilical artery histomorphometry provides a link between the intrauterine environment, vascular and kidney development.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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