Physiology and Pathophysiology of Compensatory Adaptations of a Solitary Functioning Kidney

Frontiers in Physiology
Zoe McArdleReetu R Singh

Abstract

Children born with a solitary functioning kidney (SFK) have an increased risk of hypertension and kidney disease from early in adulthood. In response to a reduction in kidney mass, the remaining kidney undergoes compensatory kidney growth. This is associated with both an increase in size of the kidney tubules and the glomeruli and an increase in single nephron glomerular filtration rate (SNGFR). The compensatory hypertrophy and increase in filtration at the level of the individual nephron results in normalization of total glomerular filtration rate (GFR). However, over time these same compensatory mechanisms may contribute to kidney injury and hypertension. Indeed, approximately 50% of children born with a SFK develop hypertension by the age of 18 and 20-40% require dialysis by the age of 30. The mechanisms that result in kidney injury are only partly understood, and early biomarkers that distinguish those at an elevated risk of kidney injury are needed. This review will outline the compensatory adaptations to a SFK, and outline how these adaptations may contribute to kidney injury and hypertension later in life. These will be based largely on the mechanisms we have identified from our studies in an ovine model of SFK, that imp...Continue Reading

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Citations

Dec 8, 2020·American Journal of Physiology. Renal Physiology·Edwin J BaldelomarKevin M Bennett
Jun 3, 2021·Journal of Clinical Medicine·Eryk LatochKatarzyna Taranta-Janusz
Jun 19, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Dieter HaffnerMaren Leifheit-Nestler
Aug 3, 2021·European Urology Open Science·Sander Groen In 't WoudMichiel F Schreuder

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