The Developmental Origins of Renal Dysfunction

Impairments in renal function can contribute to multiple disorders including chronic kidney disease and hypertension. Although adult onset renal dysfunction may in part be attributable to lifestyle choices or other morbidities, such as diabetes, the "developmental origins of health and disease" hypothesis has suggested that impaired renal development may predispose offspring to later renal disease. This chapter will detail the epidemiological and experimental evidence highlighting the importance of impaired kidney development in the programming of adult renal dysfunction and associated diseases. Emphasis will be placed on links between a low nephron endowment and increased risk of high blood pressure and chronic kidney disease. We will also examine the molecular and epigenetic pathways affected by maternal perturbations that may give rise to a reduction in nephron number and subsequent alterations in renal function in adult life.