Translational insights into mechanisms and preventive strategies after renal injury in neonates

A Scoping Review of Life-Course Psychosocial Stress and Kidney Function

“…From a neuroendocrine and epigenetics perspective, there is evidence suggesting that fetal, placental and maternal factors, associated through the multiple-hit hypothesis, influence the development of antenatal distress and adverse offspring outcomes by different pathways [12,53]. An adverse environment induces the long-lasting hyper-reactivity of physiological survival systems: stress responses on the maternal and fetal hypothalamicpituitary-adrenal (HPA) axis [54][55][56], immune and inflammatory responses [57,58], and energy-conserving responses [59].…”

“…The results of animal studies subject to different stress models report that prenatal and postnatal exposure to glucocorticoids is associated with: a reduced renal reserve [31,32,34,35,67,68], changes in the vascular response to vasoconstrictors [29,69], activity increase in the renin-angiotensin-aldosterone system and its renal and brain receptors [31,35], change in molecular pathways that regulate the kidney transcriptome [36,70], alterations of the immuno-inflammatory processes [71] and modifications in the baroreceptors response [29,35,72]; each of these factors jointly contributes to altered kidney development and the potentially increased risk of later life arterial hypertension and CKD [34,53,73]. Additionally, recent evidence suggests a transgenerational transmission of these alterations through epigenetic mechanisms such as chromatin remodeling and modifications of non-codifying RNA [11,52].…”