Glomerular size and the incidence of renal disease in African Americans and Caucasians

Endstage renal disease (ESRD), which is more common in African Americans (AA), is often associated with increased glomerular size. Therefore, we measured glomerular size in healthy AA and Caucasians (C) to determine whether increased glomerular size precedes overt renal disease and is a marker of a high risk for ESRD. We studied two forensic autopsy series of 90 healthy young adult AA and C, matched for age, gender, and body mass index. None had glomerular lesions. Glomerular size, expressed as mean glomerular volume and glomerular fraction of cortical volume, were compared. Mean glomerular volume in AA was significantly higher (p < 0.001) than in C. Fractional volume of the glomeruli in the cortex was also higher p < 0.04). Thus AA, a group at high risk of ESRD, have increased glomerular size prior to the appearance of renal disease. C who are susceptible to ESRD may also belong to a subset of the general population that is characterized by large glomerular size.