Complications during pregnancy and fetal development: implications for the occurrence of chronic kidney disease

Expert Rev Cardiovasc Ther. 2017 Mar;15(3):211-220. doi: 10.1080/14779072.2017.1294066. Epub 2017 Feb 16.

Abstract

Numerous epidemiological studies indicate an inverse association between birth weight and the risk for chronic kidney disease. Areas covered: Historically, the first studies to address the developmental origins of chronic disease focused on the inverse relationship between birth weight and blood pressure. A reduction in nephron number was a consistent finding in low birth weight individuals and experimental models of developmental insult. Recent studies indicate that a congenital reduction in renal reserve in conjunction with an increase in blood pressure that has its origins in fetal life increases vulnerability to renal injury and disease. Expert commentary: Limited experimental studies have investigated the mechanisms that contribute to the developmental origins of kidney disease. Several studies suggest that enhanced susceptibility to renal injury following a developmental insult is altered by sex and age. More in-depth studies are needed to clarify how low birth weight contributes to enhanced renal risk, and how sex and age influence this adverse relationship.

Keywords: Developmental origins; IUGR; chronic kidney disease; hypertension; low birth weight; nephron number.

Publication types

  • Review

MeSH terms

  • Birth Weight / physiology*
  • Blood Pressure / physiology
  • Female
  • Fetal Development / physiology*
  • Humans
  • Hypertension / physiopathology
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Kidney / physiopathology
  • Nephrons / metabolism
  • Pregnancy
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / etiology