Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, India.
Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico.
Adv Chronic Kidney Dis. 2022 May;29(3):243-250. doi: 10.1053/j.ackd.2022.02.002.
Gaining insight into the complex cycle of renal programming and its early-life clinical associations is essential to understand the origins of kidney disease. Prematurity and intrauterine growth restriction are associated with low nephron endowment. This increases the risk of developing hypertension and chronic kidney disease later in life. There is appreciable evidence to support mechanistic links between low nephron endowment secondary to intrauterine events and kidney size, kidney function, and blood pressure in postnatal life. A clear understanding of the cycle of developmental programming and consequences of fetal insults on the kidney is critical. In addition, the impact of events in the early postnatal period (accelerated postnatal growth, development of obesity, exposure to nephrotoxins) on the cardiovascular system and blood pressure of individuals born prematurely or with low birth weight is discussed. In summary, this review draws attention to the concepts of renal programming and nephron endowment and underscores the associations between intrauterine growth restriction, prematurity, and its clinical consequences in adult life.
深入了解肾脏编程的复杂循环及其与生命早期的临床关联对于理解肾脏疾病的起源至关重要。早产和宫内生长受限与肾小球数量不足有关。这增加了日后患高血压和慢性肾脏病的风险。有大量证据支持宫内事件导致的肾小球数量不足与出生后肾脏大小、肾功能和血压之间的机制联系。清楚地了解发育编程的循环以及胎儿损伤对肾脏的后果至关重要。此外，还讨论了出生后早期的事件（加速的出生后生长、肥胖的发展、接触肾毒物）对早产儿或低出生体重儿的心血管系统和血压的影响。总之，本综述提请注意肾脏编程和肾小球数量的概念，并强调了宫内生长受限、早产及其在成年期的临床后果之间的关联。
