Compensatory enlargement of a solitary functioning kidney during fetal development

Vuuren, S. H. van; Doef, R. van der; Cohen–Overbeek, Titia E.; Goldschmeding, Roel; Pistorius, L. R.; Jong, Tom P.V.M. de

doi:10.1002/uog.11168

Cited by 40 publications

(24 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compensatory enlargement of the single kidney in cases of URA during development has not been studied extensively . Hartshorne et al performed a retrospective analysis of 20 fetuses with isolated URA detected at autopsy.…”

Section: Discussionmentioning

confidence: 87%

“…Previous studies assessing compensatory growth of the solitary kidney referred to mixed population of URA and MCDK, while in all studies, the former diagnosis contributed the minority of cases. Since these two entities are a result of different mechanisms leading to aberrant renal development that may in turn trigger a varying compensatory growth programme in the contralateral normal kidney, their compensatory growth curves should be studied separately.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prenatal compensatory renal growth in unilateral renal agenesis

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Prenatal compensatory renal growth in unilateral renal agenesis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Individuals born with a solitary functioning kidney are presumed to have a congenital nephron deficiency but the time course over which functional and structural adaptations occur is less well understood. In human fetuses, between gestational ages of 20–36 weeks, 11% increase in the volume of the solitary kidney has been observed in almost 90% of fetuses . This increase in size of the solitary kidney is likely due to both hyperplasia and hypertrophy.…”

Section: Congenital Nephron Deficiency: Functional and Structural Adamentioning

confidence: 99%

Compensatory responses to nephron deficiency: Adaptive or maladaptive?

et al. 2014

View full text Add to dashboard Cite

This is a comprehensive review on our current understanding of postnatal functional and structural maturation of a kidney. We further explore how these adaptations in the setting of abnormal kidney development or loss of a kidney which result in low nephron number can lead to maladaptive phenotypes such as renal failure and hypertension later in life. ABSTRACT:Compensatory renal growth is a characteristic adaptation to reduced renal mass that appears to recapitulate the normal pattern of maturation of the kidney during the postnatal period. Hypertrophy of tubules (predominantly the proximal tubule) and glomeruli is accompanied by increased single nephron glomerular filtration rate and tubular reabsorption of sodium. We propose that the very factors, which contribute to the increase in growth and function of the renal tubular system, are, in the long term, the precursors to the development of hypertension in those with a nephron deficit. The increase in single nephron glomerular filtration rate is dependent on multiple factors, including reduced renal vascular resistance associated with an increased influence of nitric oxide, and a rightward shift in the tubuloglomerular feedback curve, both of which contribute to the normal maturation of renal function. The increased influence of nitric oxide appears to contribute to the reduction in tubuloglomerular feedback sensitivity and facilitate the initial increase in glomerular filtration rate. The increased single-nephron filtered load associated with nephron deficiency may promote hypertrophy of the proximal tubule and so increased reabsorption of sodium, and thus a rightward shift in the pressure natriuresis relationship. Normalization of sodium balance can then only occur at the expense of chronically increased arterial pressure. Therefore, alterations/adaptations in tubules and glomeruli in response to nephron deficiency may increase the risk of hypertension and renal disease in the long-term.

show abstract

“…In this setting, each nephron may have normal dimensions with subnormal single perfusion and filtration, and the risk of glomeruli injury would be proportionately reduced. Unfortunately, in these studies (9)(10)(11), nephron number was not reported. Prevalence of unilateral renal agenesis has been reported in 0.48-0.58 per 1,000 live births (12); a 13% decrease in renal function and a 47% increase in hypertension incidence have been reported in adult patients with unilateral agenesis (13).…”

mentioning

confidence: 99%

“…Moreover, kidney ultrasound studies performed during gestation show that the renal compensation begins before birth (11). In contrast to the adult, as nephrogenesis is not complete before 36 wk of gestation, enlargement of the remaining kidney could involve the formation of new nephrons.…”

mentioning

confidence: 99%

Compensatory renal growth after unilateral or subtotal nephrectomy in the ovine fetus

et al. 2013

View full text Add to dashboard Cite

Background:Clinical and experimental studies show that unilateral (1/2Nx) and subtotal nephrectomy (5/6Nx) in adults result in compensatory renal growth without formation of new nephrons. During nephrogenesis, the response to renal mass reduction has not been fully investigated. Methods: Ovine fetuses underwent 1/2Nx, 5/6Nx, or sham surgery (sham) at 70 d of gestation (term: 150 d), when nephrogenesis is active. At 134 d, renal function was determined, fetuses were killed, and kidneys were further analyzed at the cellular and molecular levels. Additional fetuses subjected to 5/6Nx were killed at 80 and 90 d of gestation to investigate the kinetics of the renal compensatory process. results: At 134 d, in 1/2Nx, a significant increase in kidney weight and estimated glomerular number was observed. In 5/6Nx, the early and marked catch-up in kidney weight and estimated glomerular number was associated with a striking butterfly-like remodeling of the kidney that developed within the first 10 d following nephrectomy. In all groups, in utero glomerular filtration rates were similar. conclusion: Compensatory renal growth was observed after parenchymal reduction in both models; however, the resulting compensatory growth was strikingly different. After 5/6Nx, the remnant kidney displayed a butterfly-like remodeling, and glomerular number was restored.

show abstract

Compensatory enlargement of a solitary functioning kidney during fetal development

Abstract: ABSTRACT

Cited by 40 publications

References 21 publications

Prenatal compensatory renal growth in unilateral renal agenesis

Prenatal compensatory renal growth in unilateral renal agenesis

Compensatory responses to nephron deficiency: Adaptive or maladaptive?

Compensatory renal growth after unilateral or subtotal nephrectomy in the ovine fetus

Contact Info

Product

Resources

About