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Alterations in fetal kidney development and increased risk for adult diseases

Carlos Grandi1,2

  • 1Subcomisión Origen y Enfermedad en el Curso de la Vida (DOHaD), Sociedad Argentina de Pediatría, Ciudad Autónoma de Buenos Aires, Argentina. cgrandi@intramed.net.

Archivos Argentinos De Pediatria
|September 27, 2021
PubMed

Insights

Low birth weight, intrauterine growth restriction, and preterm birth can alter kidney development, increasing risks for future kidney disease. Early assessment and prevention strategies are crucial for at-risk infants.

Area of Science:

  • Nephrology
  • Developmental Biology
  • Pediatrics

Background:

  • Low birth weight (LBW), intrauterine growth restriction (IUGR), and preterm birth (PB) are common clinical factors impacting nephron number programming.
  • These conditions are linked to increased risks of hypertension, proteinuria, and kidney disease later in life.
  • Current risk assessment relies on indirect postnatal markers for evaluating future kidney disorders in at-risk newborns.

Purpose of the Study:

  • To review advances in animal experiments and human biochemical markers for assessing nephron number.
  • To discuss recommendations for preventing kidney injury, considering preconception factors, social determinants, and chronic diseases.
  • To highlight the cumulative impact of IUGR and prematurity on nephrogenesis and kidney function.

Main Methods:

  • Review of animal experimental data on nephrogenesis.
  • Analysis of human biochemical markers for kidney development assessment.
  • Synthesis of evidence on preconception care and risk factor management.

Main Results:

  • IUGR and prematurity independently affect nephrogenesis and kidney function.
  • Simultaneous occurrence of IUGR and prematurity has cumulative detrimental effects on kidney development.
  • Advances in animal models and human biomarkers offer improved risk assessment strategies.

Conclusions:

  • Altered nephron number programming due to LBW, IUGR, or PB poses significant long-term kidney health risks.
  • Early detection and intervention, including preconception care, are vital for mitigating these risks.
  • Further research into preventative strategies and refined assessment methods is warranted.

Keywords:
intrauterine growth restrictionkidney diseaseslow birth weight infantnephronspreterm birth

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