Compensatory renal hypertrophy in fetal rats

Fetal compensatory renal growth due to unilateral ureteral obstruction

To determine whether fetal compensatory renal growth occurs in response to early gestational unilateral renal obstruction and to help elucidate the characteristics of this response, a fetal lamb model was developed in which unilateral ureteral obstruction was created at 60 days of gestation (term 135 to 140 days) and the effects of the obstruction were studied at varying periods thereafter. Kidneys were retrieved at 2 weeks (75 days in 3 cases), 5 weeks (95 days in 4) and 10 weeks (135 days in 9) after obstruction, weighed and preserved for histology and biochemical studies. Deoxyribonucleic acid (DNA), ribonucleic acid and protein were quantitated using standard assays. Morphometric studies to estimate glomerular number were performed using standard stereological methods. Contralateral kidney weight was increased compared to normals in 55 cases at all ages. The relative difference increased from 75 to 95 days. The fractional increase at 135 days (49.5%, p < 0.001 versus normal) was not different from 95 days (46.4%, p = 0.87), indicating that growth rate acceleration occurred predominantly before 95 days. Total renal DNA was increased above normal at each time point, with an ultimate increment proportionate to weight. Protein concentration was unchanged, suggesting that weight increase was not due to changes in renal water. Protein/DNA ratios were unchanged, indicating a predominantly hyperplastic process. Ribonucleic acid/DNA ratios decreased, possibly indicating a high rate of proliferation. Total glomerular number at term did not increase with in utero compensatory renal growth. Unilateral ureteral obstruction created early in gestation produced compensatory renal growth of the intact kidney in the fetal lamb. This process demonstrates an early but transient growth rate acceleration, hyperplasia and no increase in total glomerular or nephron number. The occurrence of compensatory renal growth in the fetal kidney with minimal functional renal demand would suggest that its mechanisms may be independent of functional demand. This model is unique and well suited to study compensatory renal growth.

Human fetal compensatory renal growth

The occurrence of prenatal compensatory renal growth has remained in question, despite the general acceptance of this phenomenon postnatally. We measured by ultrasound imaging the renal length of 22 human fetuses with a solitary kidney or contralateral multicystic dysplastic kidney, and compared it to measurements in 40 normal control fetuses. Renal length was normalized to fetal biparietal diameter. Analysis of covariance showed that the solitary kidneys were significantly larger than normal controls (p < 0.0001), although the rate of growth was not significantly increased above normal. These data document the presence of compensatory renal growth in human fetuses with solitary or functionally solitary kidneys.

Changes in blood urea nitrogen (BUN) concentration during pregnancy in the rat with or without obstructive uremia

Bilateral ureteral ligation changes the blood urea nitrogen (BUN) concentration in pregnant and non-pregnant rats. Marked increases of the BUN concentration occurred in both pregnant and non-pregnant specimens after ligation. The BUN concentration in sham-ligated rats did not change from day 16 through 19 of pregnancy, but increased on day 20 of pregnancy and thereafter. There was no significant difference in BUN between ligated pregnant rats on days 16 and 17 of pregnancy and ligated non-pregnant rats. As pregnancy progressed from day 18 onward, the BUN in ligated pregnant rats decreased when compared with that of ligated non-pregnant rats, but did not reach the level in sham-ligated pregnant rats. The BUN of mothers and fetuses both in the ligated and the sham-ligated groups were similar. Amniotic fluid urea nitrogen levels were higher than in blood on late fetal days. In ligated mothers, a significant relationship between maternal BUN and the number of fetuses was noted on day 22 of pregnancy. These results suggest that the fetal kidney becomes functional for excreting urea in late fetal life.

Granularity of cells in the juxtaglomerular apparatus in fetal rats after maternal nephrectomy or fetal unilateral nephrectomy

Granular cell indices (GCI: Dunihue and Robertson, '57) in kidneys of fetal rats one day after maternal nephrectomy of fetal unilateral nephrectomy on day 21 of gestation were determined by examining sections stained with Bowie's technique. Maternal nephrectomy induced an extreme increase of GCI in fetal kidneys with increased granularity of cells in the juxtaglomerular apparatus. Fetal unilateral nephrectomy did not cause any significant change.