Adverse consequences of accelerated neonatal growth: cardiovascular and renal issues

Area of Science:

• Developmental biology
• Nephrology
• Public health

Background:

• Birth weight is inversely associated with adult cardiovascular and metabolic disease risk.
• Low birth weight is increasingly implicated in the development of chronic kidney disease (CKD).
• Renal factors, particularly nephron endowment, are crucial in programming hypertension and renal disease.

Purpose of the Study:

• To review the role of the kidney in the developmental origins of adult disease theory.
• To focus on the long-term effects of postnatal growth and nutrition on renal and cardiovascular health.
• To examine the kidney as both a mechanism and a target in early-life disease programming.

Main Methods:

• Review of epidemiological and experimental studies, with a focus on rodent models.
• Analysis of the "multihits" theory involving nephron endowment and postnatal growth.
• Synthesis of current understanding on early-life influences on adult renal and metabolic functions.

Main Results:

• Reduced nephron number, often seen in low birth weight, is an initial hit for adult disease.
• Rapid postnatal growth can act as a second hit, exacerbating disease risk.
• Experimental data highlight the long-term impact of postnatal nutrition and growth on renal and cardiovascular outcomes.

Conclusions:

• The kidney plays a central role in the developmental origins of adult cardiovascular, metabolic, and renal diseases.
• Early-life factors, including birth weight and postnatal nutrition, significantly program long-term kidney health.
• Understanding these early-life influences is critical for preventing adult chronic diseases.