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Cheng YJG, Chen CC, Cheng CJ. Postnatal renal tubule development: roles of tubular flow and flux. Curr Opin Nephrol Hypertens 2024; 33:518-525. [PMID: 38913022 PMCID: PMC11290981 DOI: 10.1097/mnh.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
PURPOSE OF REVIEW Postnatal renal tubule development is critical to adult kidney function. Several postnatal changes regulate the differentiation and proliferation of renal tubular cells. Here, we review the literature and our efforts on thick ascending limb (TAL) development in Bartter syndrome (BS). RECENT FINDINGS Glomerular filtrate quickly increases after birth, imposing fluid shear stress and circumferential stretch on immature renal tubules. Recent studies showed that kidney organoids under flow (superfusion) have better development of tubular structures and the expression of cilia and solute transporters. These effects are likely mediated by mechanosensors, such as cilia and the piezo1 channel. Improved renal oxygenation and sodium pump-dependent active transport can stimulate mitochondrial respiration and biogenesis. The functional coupling between transport and mitochondria ensures ATP supply for energy-demanding reactions in tubular cells, including cell cycle progression and proliferation. We recently discovered that postnatal renal medulla maturation and TAL elongation are impaired in Clc-k2-deficient BS mice. Primary cultured Clc-k2-deficient TAL cells have G1-S transition and proliferation delay. These developmental defects could be part of the early pathogenesis of BS and worsen the phenotype. SUMMARY Understanding how tubular flow and transepithelial ion fluxes regulate renal tubule development may improve the treatment of congenital renal tubulopathies.
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Affiliation(s)
- Yi-Jing G. Cheng
- Division of Nephrology, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, U.S.A
| | - Chien-Chou Chen
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Chih-Jen Cheng
- Division of Nephrology, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, U.S.A
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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Urinary Cystatin-C, a marker to assess and monitor neonatal kidney maturation and function: validation in twins. Pediatr Res 2021; 89:932-939. [PMID: 32422644 DOI: 10.1038/s41390-020-0965-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/14/2020] [Accepted: 04/29/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Nephrogenesis is a complex process of nephron formation and maturation that can be compromised by preterm delivery and intrauterine growth restriction. This study aimed to evaluate and compare urinary Cys-C levels with renal volume in a cohort of preterm and term twins, adequate for gestational age or intrauterine growth restricted, to investigate their values in different conditions of nephrogenesis. METHODS The study was performed on twins at 30-40 days of postnatal corrected age: renal volumes were measured by 3D ultrasound technology and urine samples were analyzed for Cystatin-C. A follow-up was performed by Cystatin-C. RESULTS Renal volumes in preterm and intrauterine growth-restricted twins showed values significantly lower than those observed in term twins and were inversely correlated to urinary Cystatin-C levels. During the follow-up, intrauterine growth-restricted twins showed amplified levels of urinary Cystatin-C; in contrast, invariable or decreased levels were observed in adequate for gestational age twins. CONCLUSIONS Urinary Cystatin-C, evaluated when intrauterine/extrauterine nephrogenesis could be considered completed, concurrently with renal volume assessment can improve the identification of neonates with initial kidney impairment. Its potential value as a useful marker in monitoring physiological/pathological renal conditions could be considered, mainly for neonates at elevated risk of developing long-term renal diseases. IMPACT Urinary Cys-C levels are inversely correlated to renal volumes and reflect nephrogenesis conditions. No data in literature are reported regarding: (a) the concurrent assessment of renal volumes and urinary levels of Cystatin-C in preterm and term twins with different conditions of gestational life, i.e., AGA and IUGR and (b) the follow-up of IUGR and preterm neonates using the urinary Cys-C determination. The variations of urinary Cys-C levels, observed in the follow-up of preterm and/or IUGR neonates, support the usefulness of monitoring those neonates with altered nephrogenesis, who are later at risk for renal impairment and for long-term renal diseases.
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Brennan S, Watson D, Rudd D, Schneider M, Kandasamy Y. Evaluation of fetal kidney growth using ultrasound: A systematic review. Eur J Radiol 2017; 96:55-64. [PMID: 29103476 DOI: 10.1016/j.ejrad.2017.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/06/2017] [Accepted: 09/22/2017] [Indexed: 01/24/2023]
Abstract
PURPOSE To determine the role of ultrasound imaging in evaluating fetal kidney growth. METHODS MEDLINE, CINAHL and EMBASE databases were electronically searched for studies between 1996 and January 2017 and limited to English language. Studies were included if they reported on an ultrasound technique to assess fetal kidney growth and they were not a case report or case series. There was independent selection of studies by two reviewers in consensus with one other reviewer. Data were extracted by one reviewer in consensus with two other reviewers. RESULTS A total of 1785 articles were identified. The full text of 39 of these were assessed for eligibility for inclusion. Twenty-eight studies were then included in the review. Standard two dimensional (2D) fetal renal measurements are easy to perform, however, this review identified that most studies had some methodological limitations. The disadvantage with 2D and three dimensional (3D) fetal renal volumes are that they include the entire kidney and good reproducibility of 3D volumes has not yet been demonstrated. Currently there is limited research on fetal kidney growth in the setting of abnormal fetal growth. Research focussing directly on fetal kidney parenchyma and blood flow is scarce. CONCLUSIONS Some nomograms of 2D and 3D fetal kidney size and volume have been developed. Kidney length is the most popular single fetal kidney measurement; however, it does not seem to be a good indicator of growth. In IUGR fetuses, kidney length remained similar to appropriately grown fetuses whereas AP and TS dimensions were significantly decreased. New ultrasound techniques focusing on the parenchyma of the kidney and perfusion to the kidney should be explored as they may provide more meaningful information on kidney development in the fetus and future kidney function.
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Affiliation(s)
- Sonja Brennan
- Ultrasound Department, The Townsville Hospital, IMB 47 P.O. Box 670, Douglas, Townsville, Queensland, 4810, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia.
| | - David Watson
- Department of Obstetrics and Gynaecology, The Townsville Hospital, IMB 85 P.O. Box 670, Townsville, Queensland 4810, Australia
| | - Donna Rudd
- College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia
| | - Michal Schneider
- Department of Medical Imaging and Radiation Sciences, School of Primary And Allied Health Care, 10 Chancellors Way, Monash University, Clayton, Victoria 3800, Australia
| | - Yogavijayan Kandasamy
- College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia; Department of Neonatology, The Townsville Hospital, IMB 51 P.O. Box 670, Townsville, Queensland 4810, Australia; Mothers and Babies Research Centre, Hunter Medical Research Institute, John Hunter Hospital, The University of Newcastle,University Drive, Callaghan, NSW 2308, Australia
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Premature ovarian insufficiency and perinatal parameters: A retrospective case-control study. Maturitas 2017; 96:72-76. [DOI: 10.1016/j.maturitas.2016.11.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/23/2016] [Accepted: 11/25/2016] [Indexed: 12/18/2022]
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Bakker H, Gaillard R, Hofman A, Reiss IK, Steegers EAP, Jaddoe VWV. Fetal first trimester growth is not associated with kidney outcomes in childhood. Pediatr Nephrol 2017; 32:651-658. [PMID: 27796619 PMCID: PMC5334431 DOI: 10.1007/s00467-016-3537-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the association of fetal first trimester growth with kidney outcomes in childhood. METHODS This study was embedded in a prospective population-based cohort study among 1176 pregnant women and their children. We used fetal first trimester crown-length as the growth measure among mothers with a regular menstrual cycle and a known first day of the last menstrual period. At the childhood age of 6 (median 5.7-6.8) years, we measured combined kidney volume, microalbuminuria and estimated glomerular filtration rate (eGFR) based on serum creatinine and cystatin C concentrations. RESULTS No consistent associations of fetal first trimester crown-rump length with childhood combined kidney volume, eGFR and microalbuminuria were observed. Compared to children with a fetal first trimester crown-rump length in the highest quintile, those in the lowest quintile had a larger childhood combined kidney volume (difference 5.32 cm3, 95 % confidence interval 1.06 to 9.57), but no differences in kidney function. CONCLUSION Our results do not support the hypothesis that fetal first trimester growth restriction affects kidney size and function in childhood. Further studies are needed to focus on critical periods in early life for kidney function and disease in later life.
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Affiliation(s)
- Hanneke Bakker
- 000000040459992Xgrid.5645.2The Generation R Study Group (Na-29-15), Erasmus University Medical Center, Box 2040, 3000 CA Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Romy Gaillard
- 000000040459992Xgrid.5645.2The Generation R Study Group (Na-29-15), Erasmus University Medical Center, Box 2040, 3000 CA Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- 000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands ,000000041936754Xgrid.38142.3cDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Irwin K. Reiss
- 000000040459992Xgrid.5645.2Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eric A. P. Steegers
- 000000040459992Xgrid.5645.2Department of Obstetrics & Gynaecology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Vincent W. V. Jaddoe
- 000000040459992Xgrid.5645.2The Generation R Study Group (Na-29-15), Erasmus University Medical Center, Box 2040, 3000 CA Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands ,000000040459992Xgrid.5645.2Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
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Sadrzadeh S, Painter RC, Lambalk CB. Developmental origins of polycystic ovary syndrome (PCOS), a case control study comparing birth weight in women with PCOS and control group. Gynecol Endocrinol 2016; 32:856-859. [PMID: 27222928 DOI: 10.1080/09513590.2016.1186632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Evidence from various epidemiological studies and experimental animal studies has linked adverse intrauterine circumstances with health problems in adult life. This field of investigation is known as Developmental Origins of Health and Disease (DOHaD). Studies investigating the relation between developing polycystic ovary syndrome (PCOS) in adulthood and birth weight have yielded inconsistent results: PCOS is described more often in women with low birth weight and high birth weight, while other studies have failed to establish any relation. In this retrospective case-control study, we evaluated whether women diagnosed with PCOS had lower birth weight compared to women with a regular menstrual cycle (controls). Binary logistic regression models were used to analyze the data and correct for known confounders. About 65 women with PCOS and 96 controls were recruited for this purpose. The average birth weight of PCOS women (3357 g) did not differ from the average birth weight of controls (3409 g). Mean age at menarche differed significantly between groups, 13.7 years and 12.8 years (p = 0.006), respectively, for PCOS women and controls. In conclusion, we could not confirm the effect of adverse intrauterine conditions, reflected in birth weight, on developing PCOS.
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Affiliation(s)
- Sheda Sadrzadeh
- a Division of Reproductive Medicine, Department of Obstetrics & Gynecology , VU University Medical Centre (VUMC) , Amsterdam , the Netherlands and
| | - Rebecca C Painter
- b Department of Obstetrics and Gynecology , Academic Medical Centre , Amsterdam , the Netherlands
| | - Cornelis B Lambalk
- a Division of Reproductive Medicine, Department of Obstetrics & Gynecology , VU University Medical Centre (VUMC) , Amsterdam , the Netherlands and
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Barbati A, Cappuccini B, Aisa MC, Grasselli C, Zamarra M, Bini V, Bellomo G, Orlacchio A, Di Renzo GC. Increased Urinary Cystatin-C Levels Correlate with Reduced Renal Volumes in Neonates with Intrauterine Growth Restriction. Neonatology 2016; 109:154-60. [PMID: 26756983 DOI: 10.1159/000441273] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 09/23/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Exposure to intrauterine growth retardation (IUGR) can have a negative impact on nephrogenesis resulting in limited fetal kidney development and supporting the hypothesis that IUGR represents a risk for renal function and long-term renal disease. Cystatin-C (Cys-C), a strong inhibitor of cysteine proteinases, is freely filtered by the kidney glomerulus and is reabsorbed by the tubules, where it is almost totally catabolized; what remains is subsequently eliminated in urine. In tubular diseases and in hyperfiltration conditions, it seems reasonable to postulate that Cys-C degradation would decrease, and consequently an increase in its urinary elimination would be observed. OBJECTIVES The aim of this study was to investigate the urinary excretion of Cys-C simultaneously with the assessment of renal volumes in adequate for gestational age (AGA) and IUGR neonates in order to identify its clinical value in IUGR. METHODS Urinary Cys-C levels were measured using the enzyme immunoassay DetectX® Human Cystatin C kit in IUGR and AGA neonates. Whole renal and renal cortex volumes were assessed with ultrasounds (Vocal II; Software, GE). RESULTS Urinary Cys-C levels in IUGR were significantly higher than those found in AGA and were negatively correlated to reduced whole renal and renal cortex volumes. CONCLUSIONS The increased levels of Cys-C in the urine of neonates with IUGR were significantly associated with reduced renal/renal cortex volumes, suggesting that Cys-C could be taken as a surrogate of nephron mass. It also could be used as an early biochemical marker to identify IUGR neonates at high risk of developing long-term renal disease and to select patients for monitoring during childhood.
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Affiliation(s)
- Antonella Barbati
- Department of Surgical and Biomedical Sciences, Section of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
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