The Kidney During Development

Spitzer, Adrian; Schwartz, George J.

doi:10.1002/cphy.cp080112

Cited by 9 publications

(4 citation statements)

References 425 publications

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“…This highly plastic pattern of renin expression seems to be common during development in all mammals; however, the mechanisms regulating this switching on and off of renin expression remains poorly understood. A detailed discussion of kidney development during embryogenesis is discussed by Spitzer et al in the Handbook of Physiology (343). Some studies have shown correlation between embryonic expression of renin and sympathetic innervation of the kidney (302), along with expression of transforming growth factor β type II receptor suggesting a possible role in regulating renin expression during development (213).…”

Section: Renin Expression During Kidney Developmentmentioning

confidence: 99%

Classical Renin‐Angiotensin System in Kidney Physiology

Sparks

Crowley

Gurley

et al. 2014

Comprehensive Physiology

445

429

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The renin-angiotensin system has powerful effects in control of the blood pressure and sodium homeostasis. These actions are coordinated through integrated actions in the kidney, cardio-vascular system and the central nervous system. Along with its impact on blood pressure, the renin-angiotensin system also influences a range of processes from inflammation and immune responses to longevity. Here, we review the actions of the “classical” renin-angiotensin system, whereby the substrate protein angiotensinogen is processed in a two-step reaction by renin and angiotensin converting enzyme, resulting in the sequential generation of angiotensin I and angiotensin II, the major biologically active renin-angiotensin system peptide, which exerts its actions via type 1 and type 2 angiotensin receptors. In recent years, several new enzymes, peptides, and receptors related to the renin-angiotensin system have been identified, manifesting a complexity that was previously unappreciated. While the functions of these alternative pathways will be reviewed elsewhere in this journal, our focus here is on the physiological role of components of the “classical” renin-angiotensin system, with an emphasis on new developments and modern concepts.

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Section: Renin Expression During Kidney Developmentmentioning

confidence: 99%

Classical Renin‐Angiotensin System in Kidney Physiology

Sparks

Crowley

Gurley

et al. 2014

Comprehensive Physiology

445

429

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“…However, kidney weight does bear a rather constant relation to body surface area (BSA) in humans and in a variety of animal species (1). In addition, the measurement of BSA has a small coefficient of variation, and scaling GFR to BSA shows that infants reach adult GFR values by 6 to 24 mo of age (2)(3)(4)(5). Because absolute GFR is strongly correlated with BSA (1) and the regression coefficient for BSA was not significantly different from 1, adjusting GFR for BSA essentially removes the variability of GFR that is caused by the variation in pediatric body size (6).…”

Section: Determination Of Gfrmentioning

confidence: 99%

Measurement and Estimation of GFR in Children and Adolescents

Schwartz

Work

2009

Clinical Journal of the American Society of Nephrology

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802

604

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GFR is the best indicator of renal function in children and adolescents and is critical for diagnosing acute and chronic kidney impairment, intervening early to prevent end-stage renal failure, prescribing nephrotoxic drugs and drugs cleared by a failing kidney, and monitoring for side effects of medications. Renal inulin clearance was the gold standard for GFR but is compromised by lack of availability, difficult assays, and problems of collecting timed urine samples, especially in children with vesicoureteral reflux or bladder dysfunction. Creatinine clearance-based estimates of GFR are often used in pediatrics. The addition of cimetidine to eliminate creatinine secretion permits accurate measurement of GFR in those who can completely empty their bladders to provide timed urine collections. Radioisotopes are used in plasma disappearance GFR determinations; however, these are not ideal for use in children, especially for repeated studies. The plasma disappearance of iohexol serves as a promising alternative GFR marker, because it is safe and not radioactive, easily measured, not metabolized or transported by the kidney, and excreted primarily by glomerular filtration. GFR estimating equations, based on serum concentrations of creatinine or cystatin C, are popular clinically and in research studies. Efforts are ongoing to improve these estimating equations for children and make the results readily available to clinicians obtaining standard chemistry profiles, as is being done for adults. However, at this time, there is no dependable substitute for an accurately determined GFR, and iohexol plasma disappearance offers the best combination of safety, accuracy, and reproducible precision.

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“…Several alternatives have been suggested as normalisation factors for kidney function: kidney weight, body weight, basal metabolic weight, BSA and extracellular volume [8,9]. The most commonly used method for the normalisation of kidney function is that of BSA, though this is empirical and its application to the TER of 99mTc-MAG3 is unsubstantiated.…”

Section: Introductionmentioning

confidence: 99%

Effect of renal maturation on the clearance of technetium-99m mercaptoacetyltriglycine

1994

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To investigate the effect of growth and maturation on the global kidney clearance of technetium-99m mercaptoacetyltriglycine (99mTc-MAG3), we investigated 509 children who attended for 99mTc-MAG3 renography in our department. In order to estimate the normal maturation of the kidney, only children who were classified as "normal" using diagnostic criteria were included in this study (n = 109). Kidney clearance was calculated using a gamma camera technique and a 20-min blood sample. There was a progressive increase in the clearance of 99mTc-MAG3 throughout childhood and into adolescence (mean clearance value below 2 month was 31.4 ml/min, mean clearance value above 12 years was 287 ml/min). When clearance was normalised to body surface area (BSA) a different pattern was seen, with a progressive increase from 3 weeks of age (mean value < 0.2 years: 208 ml/min/1.73 m2) to a plateau at the end of the first year of life (mean value > 2 years: 303 ml/min/1.73 m2). Maturation of the kidney as defined by the normalised clearance of 99mTc-MAG3 is therefore complete by the end of the 1st year of life, after which any change in non-corrected clearance values may be attributed to growth. To investigate the appropriate normalisation factor for 99mTc-MAG3 clearance in children, clearance values were compared to height, weight and BSA. The relationships were described using a linear model; the correlation coefficients demonstrated that BSA has the highest strength of relationship with 99mTc-MAG3 clearance. Body surface area may be used over 1 year of age to normalise the clearance values of 99mTc-MAG3.(ABSTRACT TRUNCATED AT 250 WORDS)

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The Kidney During Development

Abstract: The sections in this article are: Historical Perspective Standards of Reference for Comparison of Renal Function Between Infants and Adults Morphogenesis of the Kidney Embryologic Origin of the Kidney Subsequent Development of the Kidney Glomerulus Renal Tubule … Show more

Cited by 9 publications

References 425 publications

Classical Renin‐Angiotensin System in Kidney Physiology

Classical Renin‐Angiotensin System in Kidney Physiology

Measurement and Estimation of GFR in Children and Adolescents

Effect of renal maturation on the clearance of technetium-99m mercaptoacetyltriglycine

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