Review

Consequences of Intrauterine Growth Restriction for the Kidney
Michiel Schreuder^a, Henriette Delemarre-van de Waal^b, Ans van Wijk^a

Departments of
^aPediatric Nephrology and
^bPediatric Endocrinology, VU University Medical Center, Amsterdam, The Netherlands

Address of Corresponding Author

Kidney Blood Press Res 2006;29:108-125 (DOI: 10.1159/000094538)

  Key Words

• Intrauterine growth restriction
• Low birth weight
• Nephrogenesis
• Glomerular number
• Kidney function
• Glomerular hyperfiltration
• Glomerulosclerosis
• Renin-angiotensin system
• Nitric oxide
• Insulin-like growth factor I

  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.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

M.F. Schreuder
Department of Pediatric Nephrology
VU University Medical Center, PO Box 7057
NL-1007 MB Amsterdam (The Netherlands)
Tel. +31 20 444 2419, Fax +31 20 444 2918, E-Mail mf.schreuder@vumc.nl

  Article Information

Published online: July 12, 2006
Number of Print Pages : 18
Number of Figures : 1, Number of Tables : 3, Number of References : 360