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Fetale Programmierung und spätere Nierenfunktionsstörungen nach intrauteriner Wachstumsrestriktion

Fetal programming and later renal malfunction after intrauterine growth restriction

  • Leitthema
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Zusammenfassung

Große epidemiologische Untersuchungen lassen auf einen klaren Zusammenhang zwischen niedrigem Geburtsgewicht und gestörter Nierenentwicklung schließen, deren Konsequenzen sich teilweise bereits im Kindesalter bemerkbar machen. Dies betrifft sowohl die chronische Niereninsuffizienz wie v.a. auch entzündliche glomeruläre Erkrankungen. Einer der wichtigsten Mechanismen scheint die Reduktion der Nephronenzahl zu sein, wenn auch weitere Mechanismen der fetalen Programmierung zunehmend aufgeklärt werden. In den letzten Jahren mehren sich die Indizien, dass die gestörte fetale Programmierung durch postnatale Interventionen wie die Vermeidung von Hyperalimentation zumindest teilweise revidiert werden kann. Ob diese Interventionen möglicherweise auch den aggravierten Verlauf von Nierenerkrankungen nach niedrigem Geburtsgewicht positiv beeinflussen kann, muss abgewartet werden.

Abstract

Large epidemiological studies suggest that a clear relationship exists between low birth weight and adverse renal outcomes, which may begin as early as childhood. Such outcomes include renal failure as well as glomerular disease. One of the most important mechanisms is a reduction in the number of nephrons, although further mechanisms of fetal programming must also be considered. It appears likely that fetal programming may be altered postnatally, such as by avoiding hyperalimentation. Whether such interventions could potentially alter the adverse course of renal disease after a small-for-gestational-age birth remains to be seen.

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  1. Pädiatrische Nephrologie, Universitätsklinikum Erlangen, Loschgestr. 15, 91054, Erlangen, Deutschland

    J. Dötsch & C. Plank

  2. Nephropathologie, Universitätsklinikum Erlangen, Erlangen, Deutschland

    K. Amann

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  1. J. Dötsch
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  2. C. Plank
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Mit Unterstützung der DFG (SFB 423, B13 und Z2).

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Dötsch, J., Plank, C. & Amann, K. Fetale Programmierung und spätere Nierenfunktionsstörungen nach intrauteriner Wachstumsrestriktion. Nephrologe 4, 306–311 (2009). https://doi.org/10.1007/s11560-008-0261-9

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