Developmental Programming of Hypertension and Kidney Disease

Section of Neonatology, Department of Pediatrics, Hypertension and Renal Center of Excellence, Tulane University Health Sciences Center, New Orleans, LA 70112, USA.
International Journal of Nephrology 11/2012; 2012(4):760580. DOI: 10.1155/2012/760580
Source: PubMed


A growing body of evidence supports the concept that changes in the intrauterine milieu during "sensitive" periods of embryonic development or in infant diet after birth affect the developing individual, resulting in general health alterations later in life. This phenomenon is referred to as "developmental programming" or "developmental origins of health and disease." The risk of developing late-onset diseases such as hypertension, chronic kidney disease (CKD), obesity or type 2 diabetes is increased in infants born prematurely at <37 weeks of gestation or in low birth weight (LBW) infants weighing <2,500 g at birth. Both genetic and environmental events contribute to the programming of subsequent risks of CKD and hypertension in premature or LBW individuals. A number of observations suggest that susceptibility to subsequent CKD and hypertension in premature or LBW infants is mediated, at least in part, by reduced nephron endowment. The major factors influencing in utero environment that are associated with a low final nephron number include uteroplacental insufficiency, maternal low-protein diet, hyperglycemia, vitamin A deficiency, exposure to or interruption of endogenous glucocorticoids, and ethanol exposure. This paper discusses the effect of premature birth, LBW, intrauterine milieu, and infant feeding on the development of hypertension and renal disease in later life as well as examines the role of the kidney in developmental programming of hypertension and CKD.

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Available from: PubMed Central, Jan 15, 2014 · License: CC BY
    • "IUGR is associated with a several-fold increase in neonatal morbidity and mortality. In addition, evidence accumulated over the last two decades has suggested that infants with IUGR are exposed, in the long run, to a higher risk of developing chronic disease, such as obesity, hypertension , type 2 diabetes and cardiovascular disease in later, adult life (Roseboom et al. 2001; Chong and Yosypiv 2012; Luyckx et al. 2013). A recent study demonstrated that in piglets IUGR affects lipogenesis, lipid oxidation, energy supply and utilization, amino acid and protein metabolism, antioxidant ability and jejunum function after birth (He et al. 2011). "
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