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

ABSTRACT

Introduction: 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
• low birth weight
• IUGR
• hypertension
• chronic kidney disease
• nephron number

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This review was supported by the National Institutes of Health (Grants: F30DK112718, T32HL105324, HL074927, HL51971, and P20GM104357), and the American Heart Association (Grant: AHA: 19900004).