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Wood-Bradley RJ, Henry SL, Barrand S, Giot A, Eipper L, Bertram JF, Cullen-McEwen LA, Armitage JA. Analysis of structure and gene expression in developing kidneys of male and female rats exposed to low protein diets in utero. Anat Rec (Hoboken) 2020; 303:2657-2667. [PMID: 32567250 DOI: 10.1002/ar.24417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/24/2019] [Accepted: 01/17/2020] [Indexed: 01/10/2023]
Abstract
A maternal low protein (LP) diet in rodents often results in low nephron endowment and renal pathophysiology in adult life, with outcomes often differing between male and female offspring. Precisely how a maternal LP diet results in low nephron endowment is unknown. We conducted morphological and molecular studies of branching morphogenesis and nephrogenesis to identify mechanisms and timepoints that might give rise to low nephron endowment. Sprague-Dawley rats were fed a normal protein (19.4% protein, NP) or LP (9% protein) diet for 3 weeks prior to mating and throughout gestation. Embryonic day 14.25 (E14.25) kidneys from males and females were either cultured for 2 days after which branching morphogenesis was quantified, or frozen for gene expression analysis. Real-time PCR was used to quantify expression of key nephrogenesis and branching morphogenesis genes at E14.25 and 17.25. At E17.25, nephron number was determined in fixed tissue. There was no effect of either maternal diet or sex on branching morphogenesis. Nephron number at E17.25 was 14% lower in male and female LP offspring than in NP controls. At E14.25 expression levels of genes involved in branching morphogenesis (Gfrα1, Bmp4, Gdnf) and nephrogenesis (Hnf4a, Pax2, Wnt4) were similar in the dietary groups, but significant differences between sexes were identified. At E17.25, expression of Gfrα1, Gdnf, Bmp4, Pax2 and Six2 was lower in LP offspring than NP offspring, in both male and female offspring. These findings provide new insights into how a LP diet leads to low nephron endowment and renal sexual dimorphism.
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Affiliation(s)
- Ryan J Wood-Bradley
- School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia.,Department of Anatomy and Developmental Biology, and Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - Sarah L Henry
- Department of Anatomy and Developmental Biology, and Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia.,Mater Research Institute, The University of Queensland, Brisbane, Australia
| | - Sanna Barrand
- School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia
| | - Anais Giot
- School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia
| | - Luke Eipper
- Department of Anatomy and Developmental Biology, and Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - John F Bertram
- Department of Anatomy and Developmental Biology, and Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - Luise A Cullen-McEwen
- Department of Anatomy and Developmental Biology, and Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
| | - James A Armitage
- School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia.,Department of Anatomy and Developmental Biology, and Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
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Flynn JT, Ng DK, Chan GJ, Samuels J, Furth S, Warady B, Greenbaum LA. The effect of abnormal birth history on ambulatory blood pressure and disease progression in children with chronic kidney disease. J Pediatr 2014; 165:154-162.e1. [PMID: 24698454 PMCID: PMC4074552 DOI: 10.1016/j.jpeds.2014.02.051] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 01/13/2014] [Accepted: 02/20/2014] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine the associations between abnormal birth history (birth weight <2500 g, gestational age <36 weeks, or small for gestational age), blood pressure (BP), and renal function among 332 participants (97 with abnormal and 235 with normal birth history) in the Chronic Kidney Disease in Children Study, a cohort of children with chronic kidney disease (CKD). STUDY DESIGN Casual and 24-hour ambulatory BP were obtained. Glomerular filtration rate (GFR) was determined by iohexol disappearance. Confounders (birth and maternal characteristics, socioeconomic status) were used to generate predicted probabilities of abnormal birth history for propensity score matching. Weighted linear and logistic regression models with adjustment for quintiles of propensity scores and CKD diagnosis were used to assess the impact of birth history on BP and GFR. RESULTS Age at enrollment, percent with glomerular disease, and baseline GFR were similar between the groups. Those with abnormal birth history were more likely to be female, of Black race or Hispanic ethnicity, to have low household income, or part of a multiple birth. Unadjusted BP measurements, baseline GFR, and change in GFR did not differ significantly between the groups; no differences were seen after adjusting for confounders by propensity score matching. CONCLUSIONS Abnormal birth history does not appear to have exerted a significant influence on BP or GFR in this cohort of children with CKD. The absence of an observed association is likely secondary to the dominant effects of underlying CKD and its treatment.
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Affiliation(s)
- Joseph T Flynn
- Division of Nephrology, Seattle Children's Hospital, and Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.
| | - Derek K Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Grace J Chan
- Division of Medicine Critical Care, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Joshua Samuels
- Division of Pediatric Nephrology and Hypertension, Department of Pediatrics, University of Texas Medical School at Houston, Houston, TX
| | - Susan Furth
- Division of Nephrology, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania, Philadelphia, PA
| | - Bradley Warady
- Division of Nephrology, Children's Mercy Hospital: Department of Pediatrics, University of Missouri-Kansas City, Kansas City, MO
| | - Larry A. Greenbaum
- Division of Pediatric Nephrology, Children's Healthcare of Atlanta; Department of Pediatrics, Emory University, Atlanta, GA
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Abitbol CL, Rodriguez MM. The long-term renal and cardiovascular consequences of prematurity. Nat Rev Nephrol 2012; 8:265-74. [PMID: 22371245 DOI: 10.1038/nrneph.2012.38] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Infants born prematurely at <37 weeks' gestation account for over 80% of infants weighing <2,500 g at birth-low birth weight (LBW) infants. This designation remains the surrogate marker for developmental origins of adult disease. Landmark studies spanning four decades have shown that individuals born with a LBW are more likely to develop cardiovascular and renal disease in later life, which is believed to be related to 'developmental programming' of such adult disease during vulnerable periods of growth in utero and in the early postnatal period. There has long been ambiguity regarding the distinction between infants with intrauterine growth restriction and preterm infants since both show a low nephron endowment that is associated with subsequent hypertension and chronic kidney disease. Knowledge is growing specific to the preterm infant and the developmental associations of being born preterm with the interruption of normal organogenesis relative to the vascular tree and kidney. Both systems develop by branching morphogenesis and interruptions lead to considerable deficits in their structure and function. These developmental aberrations can lead to endothelial dysfunction, hypertension, proteinuria and metabolic abnormalities that persist throughout life. This Review will examine the effect of preterm birth on the development of cardiovascular and kidney disease in later life and will also discuss potential early interventions to alter the progression of disease.
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Affiliation(s)
- Carolyn L Abitbol
- Division of Pediatric Nephrology, Department of Pediatrics, Holtz Children's Hospital, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
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Atzori L, Mussap M, Noto A, Barberini L, Puddu M, Coni E, Murgia F, Lussu M, Fanos V. Clinical metabolomics and urinary NGAL for the early prediction of chronic kidney disease in healthy adults born ELBW. J Matern Fetal Neonatal Med 2011; 24 Suppl 2:40-3. [DOI: 10.3109/14767058.2011.606678] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
Abundant evidence supports the association between low birth weight (LBW) and renal dysfunction in humans. Anatomic measurements of infants, children, and adults show significant inverse correlation between LBW and nephron number. Nephron numbers are also lower in individuals with hypertension compared with normotension among white and Australian Aboriginal populations. The relationship between nephron number and hypertension among black individuals is still unclear, although the high incidence of LBW predicts low nephron number in this population as well. LBW, a surrogate for low nephron number, also associates with increasing BP from childhood to adulthood and increasing risk for chronic kidney disease in later life. Because nephron numbers can be counted only postmortem, surrogate markers such as birth weight, prematurity, adult height, reduced renal size, and glomerulomegaly are potentially useful for risk stratification, for example, during living-donor assessment. Because early postnatal growth also affects subsequent risk for higher BP or reduced renal function, postnatal nutrition, a potentially modifiable factor, in addition to intrauterine effects, has significant influence on long-term cardiovascular and renal health.
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Affiliation(s)
- Valerie A Luyckx
- Department of Medicine, HMRC 260, University of Alberta, Edmonton, Canada, T6G 2S2.
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Howard VJ, Woolson RF, Egan BM, Nicholas JS, Adams RJ, Howard G, Lackland DT. Prevalence of hypertension by duration and age at exposure to the stroke belt. JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION : JASH 2010; 4:32-41. [PMID: 20374949 PMCID: PMC2872151 DOI: 10.1016/j.jash.2010.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Revised: 01/29/2010] [Accepted: 02/02/2010] [Indexed: 01/22/2023]
Abstract
Geographic variation in hypertension is hypothesized as contributing to the stroke belt, an area in the southeastern United States with high stroke mortality. No study has examined hypertension by lifetime exposure to the stroke belt. This association was studied in 19,385 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national population-based cohort. Prevalent hypertension was defined as systolic blood pressure >/=140, diastolic blood pressure >/=90, or use of antihypertensive medications. Stroke belt exposure was assessed by residence at birth, currently, early childhood, adolescence, early adulthood, mid-adulthood, and recently. After adjustment for age, race, sex, physical activity level, body mass index, smoking, alcohol, education, and income, the prevalence of hypertension was significantly more strongly related (P < .0001) with lifetime exposure, adolescence, or early adulthood exposure than exposures at other times. Birthplace and current residence were independently associated with hypertension; however, lifetime, adolescence, or early adulthood exposures were more predictive than joint model with both birthplace and current residence. That adolescence and early adulthood periods are more predictive than residence in the stroke belt for most recent 20-year period suggests community and environmental strategies to prevent hypertension need to start earlier in life.
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Affiliation(s)
- Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
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