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Pre-natal Development of the Kidneys and Urinary Tract

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Pediatric Nephrology

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Abstract

The mammalian kidney and lower urinary tract maintains and regulates water balance, acid–base homeostasis, electrolyte equilibrium, and waste excretion. The performance of these activities depends on the development of specific cell types in a precise temporal and spatial pattern. Defects in the process can lead to insufficient numbers of nephrons and/or dysfunctional ureters and/or bladders that fail to propel urine forward leading to secondary renal defects. Over the past several decades, considerable advances have been made in understanding the molecular basis for this developmental program. Defects in this program result in congenital anomalies of the kidney and urinary tract (CAKUT), which are leading causes of chronic kidney disease and renal failure in children. These developmental disorders range from renal malformations, such as renal aplasia (absence of the kidney), dysplasia (failure of normal renal differentiation), and hypoplasia (smaller kidneys), to urinary tract abnormalities such as hydronephrosis, vesicoureteral reflux, and duplicated collecting systems. Moreover, many of the molecules identified in animal models as critical for renal development have been validated as important in human CAKUT. This chapter describes renal embryology and molecular control of kidney and urinary tract development, as a means to understand the developmental origins of human CAKUT.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Nephrology, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Jacqueline Ho & Sunder Sims-Lucas

  2. Department of Pediatrics, Division of Pediatric Nephrology, The Children’s Hospital at Montefiore, Bronx, NY, USA

    Kimberly Reidy

  3. Division of Pediatric Nephrology, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Carlton M. Bates

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  1. Carlton M. Bates
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  2. Jacqueline Ho
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  3. Sunder Sims-Lucas
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  4. Kimberly Reidy
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Correspondence to Carlton M. Bates .

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Editors and Affiliations

  1. Division of Nephrology, Department of Pediatric Specialties, Bambino Gesù Children’s Hospital – IRCCS, Rome, Italy

    Francesco Emma

  2. Division of Nephrology and Hypertension, The Heart Institute, Cincinnati Children’s Hospital Medical Center, College of Medicine, Cincinnati, OH, USA

    Stuart L. Goldstein

  3. Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

    Arvind Bagga

  4. Division of Pediatric Nephrology, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Carlton M. Bates

  5. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children, NHS Foundation Trust and University College London Institute of Child Health, London, UK

    Rukshana Shroff

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Bates, C.M., Ho, J., Sims-Lucas, S., Reidy, K. (2022). Pre-natal Development of the Kidneys and Urinary Tract. In: Emma, F., Goldstein, S.L., Bagga, A., Bates, C.M., Shroff, R. (eds) Pediatric Nephrology. Springer, Cham. https://doi.org/10.1007/978-3-030-52719-8_1

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