Intrauterine growth restriction is associated with persistent juxtamedullary expression of renin in the fetal kidney

Intrauterine growth restriction is associated with persistent juxtamedullary expression of renin in the fetal kidney.BackgroundIntrauterine growth restriction (IUGR) has been linked to impaired renal function and hypertension, suggesting that an adverse prenatal environment could alter kidney development and renin production.MethodsImmunohistochemistry and in situ hybridization were employed to localize renin-containing cells (RCCs) in the deep, middle, and superficial zones of autopsy kidney sections, in parallel with histologic maturation, from unexplained stillborn fetuses of normal weight (N = 26) and stillborn fetuses with IUGR (N = 17).ResultsIn the control group, the number of RCC per 100 glomeruli in the deep zone decreased with advancing gestation from 40 at 20weeks gestation to five at term (P < 0.001), whereas the opposite change was found in the superficial zone (increase from 5 per 100 to 55 per 100; P < 0.001). In the IUGR group, the density of RCCs in both the superficial and deep zones was similar to the control group at 20weeks, and no shift in renin gene expression was observed as gestation advanced. Histologic maturation was unaltered.ConclusionsRenin gene expression persists and predominates in the deep renal cortex of the stillborn IUGR fetus, and could contribute to the pathogenesis of neonatal oliguria and/or hypertension during postnatal life