Gattineni Jyothsna, Baum Michel
Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9061, USA.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Pediatr Nephrol. 2015 Dec;30(12):2085-98. doi: 10.1007/s00467-013-2666-6. Epub 2013 Nov 20.
The adult kidney maintains a constant volume and composition of extracellular fluid despite changes in water and salt intake. The neonate is born with a kidney that has a small fraction of the glomerular filtration rate of the adult and immature tubules that function at a lower capacity than that of the mature animal. Nonetheless, the neonate is also able to maintain a constant extracellular fluid volume and composition. Postnatal renal tubular development was once thought to be due to an increase in the transporter abundance to meet the developmental increase in glomerular filtration rate. However, postnatal renal development of each nephron segment is quite complex. There are isoform changes of several transporters as well as developmental changes in signal transduction that affect the capacity of renal tubules to reabsorb solutes and water. This review will discuss neonatal tubular function with an emphasis on the differences that have been found between the neonate and adult. We will also discuss some of the factors that are responsible for the maturational changes in tubular transport that occur during postnatal renal development.
尽管水和盐的摄入量有所变化,但成年肾脏能维持细胞外液的体积和成分恒定。新生儿出生时,其肾脏的肾小球滤过率仅为成年人的一小部分,肾小管也未成熟,功能能力低于成年动物。尽管如此,新生儿仍能够维持细胞外液体积和成分的恒定。出生后肾小管的发育曾被认为是由于转运蛋白丰度增加,以满足肾小球滤过率的发育性增加。然而,每个肾单位节段的出生后肾脏发育相当复杂。几种转运蛋白存在同工型变化,信号转导也有发育性变化,这些都会影响肾小管重吸收溶质和水的能力。本综述将讨论新生儿肾小管功能,重点关注新生儿与成年人之间已发现的差异。我们还将讨论一些导致出生后肾脏发育过程中肾小管转运成熟变化的因素。