title: Accelerated maturation and abnormal morphology in the preterm neonatal kidney.
abstract: Nephrogenesis is ongoing at the time of birth for the majority of preterm infants, but whether postnatal renal development follows a similar trajectory to normal in utero growth is unknown. Here, we examined tissue collected at autopsy from 28 kidneys from preterm neonates, whose postnatal survival ranged from 2 to 68 days, including 6 that had restricted intrauterine growth. In addition, we examined kidneys from 32 still-born gestational controls. We assessed the width of the nephrogenic zone, number of glomerular generations, cross-sectional area of the renal corpuscle, and glomerular maturity and morphology. Renal maturation accelerated after preterm birth, with an increased number of glomerular generations and a decreased width of the nephrogenic zone in the kidneys of preterm neonates. Of particular concern, compared with gestational controls, preterm kidneys had a greater percentage of morphologically abnormal glomeruli and a significantly larger cross-sectional area of the renal corpuscle, suggestive of renal hyperfiltration. These observations suggest that the preterm kidney may have fewer functional nephrons, thereby increasing vulnerability to impaired renal function in both the early postnatal period and later in life.
authors.affiliation: Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Monash University, Clayton, Victoria, 3800, Australia.
authors.forename: Megan R
authors.initials: MR
authors.lastname: Sutherland
authors.forename: Lina
authors.initials: L
authors.lastname: Gubhaju
authors.forename: Lynette
authors.initials: L
authors.lastname: Moore
authors.forename: Alison L
authors.initials: AL
authors.lastname: Kent
authors.forename: Jane E
authors.initials: JE
authors.lastname: Dahlstrom
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Hoy
authors.forename: John F
authors.initials: JF
authors.lastname: Bertram
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Black
mesh_terms: D002423:Cause of Death; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007678:Kidney Glomerulus / Q000002:abnormalities / Q000254:growth & development*; D008297:Male; D047928:Premature Birth / Q000188:drug therapy / Q000401:mortality