Nephron Number and Primary Hypertension

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Abstract
Keller et al. (Jan. 9 issue)1 report that patients with hypertension have fewer nephrons than do age-matched normotensive controls. Is hypertension therefore predetermined by a low nephron number, and, if so, how does this occur? Reduction of the surface area of glomerular capillaries, resulting in a limitation of sodium filtration, does not explain the findings, since kidney donation is not associated with hypertension, even many years later.2