Normal variation in nephron numbers
Kidney development includes the formation of nephrons, which ceases around the 36th week of gestation. At that time, around 900,000 nephrons are formed, but with a 10-fold variation (from 200,000 to over 2 million). Many factors have been described to influence the number of nephrons per individual, such as genetic variations, intrauterine growth and prematurity, maternal diseases and (nutritional) deficiencies, and drugs used during nephrogenesis. Counting nephrons is currently only possible ex vivo, even though magnetic resonance imaging techniques are getting to the stage that in vivo estimations using stereology (the gold standard methodology) can be expected to become available in the next decade. In the meantime, renal size is often used as a marker for nephron endowment.