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Developmental programming of hypertension and kidney disease

Euming Chong1, Ihor V Yosypiv

  • 1Section of Neonatology, Department of Pediatrics, Hypertension and Renal Center of Excellence, Tulane University Health Sciences Center, New Orleans, LA 70112, USA.

International Journal of Nephrology
|December 20, 2012
PubMed

Insights

Early life factors like premature birth and low birth weight can program later health, increasing risks for hypertension and chronic kidney disease (CKD) due to reduced nephron endowment.

Area of Science:

  • Developmental biology
  • Nephrology
  • Public health

Background:

  • Developmental programming, or developmental origins of health and disease, links early life conditions to later health outcomes.
  • Premature birth (<37 weeks gestation) and low birth weight (<2,500g) are associated with increased risk of late-onset diseases.
  • Chronic kidney disease (CKD) and hypertension risk in these infants may stem from reduced nephron endowment.

Purpose of the Study:

  • To discuss the impact of premature birth, low birth weight, intrauterine environment, and infant feeding on hypertension and renal disease development.
  • To examine the kidney's role in the developmental programming of hypertension and CKD.

Main Methods:

  • Literature review and synthesis of existing evidence.
  • Analysis of factors influencing intrauterine development and nephron endowment.
  • Discussion of the relationship between early life events and adult-onset disease.

Main Results:

  • Reduced nephron endowment is a key factor in the susceptibility to CKD and hypertension in premature or LBW infants.
  • Uteroplacental insufficiency, maternal diet, hyperglycemia, vitamin A deficiency, glucocorticoid disruption, and ethanol exposure can lead to low nephron number.
  • The intrauterine environment and infant feeding significantly influence long-term renal and cardiovascular health.

Conclusions:

  • Early life interventions targeting the intrauterine milieu and infant nutrition are crucial for preventing later-life hypertension and CKD.
  • Understanding developmental programming is essential for improving long-term health outcomes in vulnerable infants.
  • The kidney plays a central role in mediating the effects of early life exposures on adult health.

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