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Fetal programming of renal function

Jörg Dötsch1, Christian Plank, Kerstin Amann

  • 1Department of Pediatrics, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. Joerg.doetsch@uk-koeln.de

Pediatric Nephrology (Berlin, Germany)
|February 8, 2011
PubMed

Insights

Low birth weight can lead to adverse kidney outcomes in children due to fetal programming. Postnatal nutrition may influence these programmed renal outcomes.

Area of Science:

  • Nephrology
  • Developmental Biology
  • Epidemiology

Background:

  • Large epidemiological studies link low birth weight to adverse renal outcomes in childhood.
  • Fetal programming, influenced by maternal factors like diabetes, smoking, and glucocorticoid use, can lead to conditions such as glomerular disease, hypertension, and renal failure.
  • Clinical data on the impact of maternal glucocorticoid use during pregnancy on fetal renal programming are limited.

Purpose of the Study:

  • To discuss the potential mechanisms underlying fetal programming of renal outcomes.
  • To explore how factors during pregnancy and postnatal life may influence kidney development and long-term renal health.

Main Methods:

  • Review of existing epidemiological data.
  • Discussion of proposed biological mechanisms.
  • Synthesis of current understanding on fetal programming and renal health.

Main Results:

  • Low birth weight is associated with reduced nephron number due to diminished nephrogenesis.
  • Alterations in the intrarenal renin-angiotensin-aldosterone system and endothelial dysfunction are implicated in adverse renal outcomes.
  • Postnatal factors, such as nutritional intake, can modify the outcomes of fetal programming.

Conclusions:

  • Fetal programming initiated by factors like low birth weight can have lasting adverse effects on renal health.
  • Understanding these mechanisms is crucial for developing interventions to prevent childhood kidney disease.
  • Further clinical research is needed to elucidate the precise impact of specific maternal exposures.

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