I. Normal Development of Human Kidney and Lower Urinary Tract II. Varied Phenotypes of Human Kidney and Lower Urinary Tract Maldevelopment III. Causes of Maldevelopment of Human Kidney and Lower Urinary Tract References

Normal development of the human kidney and lower urinary tract is a highly complex process that not uncommonly goes wrong. Furthermore, congenital malformations of these structures, involving absent, immature, or poorly-grown organs, account for most young children with long-term kidney failure who require dialysis and transplantation. Evidence is emerging that some of these individuals have mutations of genes, such as transcription factors, expressed in prenatal development of the kidney and ureter. In other patients, physical obstruction of the lower tracts causes urinary flow impairment, an event that triggers diverse aberrations of kidney development, and teratogens can occasionally be identified. It is also possible that modifications of maternal diet may affect kidney development, although this hypothesis is currently more persuasive for animal models than for human disease. Understanding the mechanisms of pathogenesis of these diseases is important for genetic counseling, avoidance of possible teratogens, and planning possible therapeutic interventions, including surgical decompression of obstructed, fetal urinary tracts. I. Normal Development of Human Kidney and Lower Urinary Tract