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Renal programming: cause for concern?

Michelle M Kett1, Kate M Denton

  • 1Department of Physiology, Monash University, Clayton, Victoria, Australia.

American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
|December 31, 2010
PubMed
Summary
This summary is machine-generated.

Adverse prenatal conditions can alter kidney development, impacting lifelong renal function and increasing risks for hypertension and kidney disease. However, postnatal factors offer opportunities to mitigate these risks.

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Area of Science:

  • Nephrology
  • Developmental Biology
  • Pediatric Medicine

Background:

  • Intrauterine conditions can program kidney development, affecting nephron endowment and renin-angiotensin system activity.
  • Adverse fetal environments can lead to impaired renal function at birth, increasing long-term risks for hypertension and kidney disease.
  • Key intrarenal factors sensitive to programming include kidney mass, renin-angiotensin system, sodium handling, and renal sympathetic nerves.

Purpose of the Study:

  • To highlight the impact of in utero environmental factors on kidney development.
  • To underscore the link between early-life renal programming and adult cardiovascular and renal disease risk.
  • To emphasize the need for understanding postnatal maturation and influencing factors to predict and prevent disease.

Main Methods:

  • Review of established knowledge on fetal programming of renal development.
  • Analysis of intrarenal factors affected by suboptimal intrauterine environments.
  • Discussion of the implications of renal programming for postnatal health and disease risk.

Main Results:

  • Kidney development is sensitive to the intrauterine environment, influencing critical factors like nephron endowment.
  • Newborns with programmed kidneys face immediate challenges in fluid homeostasis and are at higher risk for adult hypertension and renal disease.
  • Evidence suggests that renal programming is not deterministic, with postnatal factors playing a crucial role.

Conclusions:

  • Early-life renal programming establishes a foundation for future health, with significant implications for cardiovascular and renal outcomes.
  • Understanding postnatal renal maturation and the influence of factors like genetics, diet, and stress is crucial for risk prediction.
  • Interventions targeting postnatal development may offer pathways to mitigate the long-term consequences of adverse fetal programming.