title: Consequences of intrauterine growth restriction for the kidney.
abstract: Low birth weight due to intrauterine growth restriction is associated with various diseases in adulthood, such as hypertension, cardiovascular disease, insulin resistance and end-stage renal disease. The purpose of this review is to describe the effects of intrauterine growth restriction on the kidney. Nephrogenesis requires a fine balance of many factors that can be disturbed by intrauterine growth restriction, leading to a low nephron endowment. The compensatory hyperfiltration in the remaining nephrons results in glomerular and systemic hypertension. Hyperfiltration is attributed to several factors, including the renin-angiotensin system (RAS), insulin-like growth factor (IGF-I) and nitric oxide. Data from human and animal studies are presented, and suggest a faltering IGF-I and an inhibited RAS in intrauterine growth restriction. Hyperfiltration makes the kidney more vulnerable during additional kidney disease, and is associated with glomerular damage and kidney failure in the long run. Animal studies have provided a possible therapy with blockage of the RAS at an early stage in order to prevent the compensatory glomerular hyperfiltration, but this is far from being applicable to humans. Research is needed to further unravel the effect of intrauterine growth restriction on the kidney.
authors.affiliation: Department of Pediatric Nephrology, VU University Medical Center, Amsterdam, The Netherlands. mf.schreuder@vumc.nl
authors.forename: Michiel
authors.initials: M
authors.lastname: Schreuder
authors.forename: Henriette
authors.initials: H
authors.lastname: Delemarre-van de Waal
authors.forename: Ans
authors.initials: A
authors.lastname: van Wijk
mesh_terms: D000818:Animals; D017209:Apoptosis; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007231:Infant, Newborn; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D007668:Kidney / Q000503:physiopathology*; D023421:Models, Animal; D008954:Models, Biological; D009569:Nitric Oxide / Q000378:metabolism; D011247:Pregnancy; D051381:Rats; D012084:Renin-Angiotensin System; D012756:Sheep; D013552:Swine; D014527:Uric Acid / Q000378:metabolism
chemical_list: D014527:Uric Acid; D009569:Nitric Oxide; D007334:Insulin-Like Growth Factor I