The early development of the kidney and implications for future health

The kidney is a relative newcomer among the organ systems for which relevance of the developmental origins hypothesis has been explored. Nephrology is a young discipline, to which epidemiologic principles have only been recently applied, and although the availability of renal replacement therapy in westernized countries has created a large group of people with end stage renal disease who can be studied in retrospect, attention has only recently focused on the vastly greater numbers of people with earlier stages of chronic kidney disease, and their accentuated cardiovascular risk. Development of the human kidney is influenced by genetic and epigenetic factors, by maternal nutritional status, maternal stature and the intrauterine environment, the length of gestation, the neonatal course and by postnatal nutrition. Many factors that influence kidney development also influence other developing organ systems. This paper summarizes some of the current knowledge and the implications of kidney development for future health, much of which have also been described in other recent reviews.