Anatomy and ontogeny of kidney development

Introduction Concerns about prenatal diagnosis of congenital renal disease (Morcel et al 2011; Gérard-Blanluet et al 2011; Amsalem et al 2011) and changes in the deterministic background, accounting new risk factors (Sun et al 2010; Harewood et al 2010; Martinovic-Bouriel et al 2010; Dührsen et al 2011, Demirel et al 2011), justify the normal development of the kidneys. Fetal ultrasound examination should be performed based on a rigorous “checklist” program (Syngelaki et al 2011) for a careful fetal anatomy scan (Stoll et al 2010; Abdelazim et al 2010; Taori et al 2010). In the UK, NICE (National Institute for Clinical Excellence) recommends to perform two ultrasound examinations on pregnant women (National Collaborating Centre for Women’s and Children’s Health 2008). According to this program, the second examination performed at 20 weeks of pregnancy is aimed at identifying fetal structural abnormalities. Detection rate (Harewood et al 2010) of some anomalies (including renal anomalies) was compared with data reported by “European Network for Surveillance of Congenital Anomalies”, including figures provided by medical records from 20 countries, figures covering 28% of all births in the European Union. (Garn et al 2000; Harewood et al 2010). Renal agenesis or dysgenesis are potentially fatal birth defects affecting 2 to 5 children per 10,000 live births annually in the United States (Davis et al 2010). According to the National Center on Birth Defects and Developmental Disabilities (2006), 3 to 5 children are born to diabetic mothers in the United States every year. Maternal diabetes, known as a risk factor for other birth defects, is also increasingly recognized for renal agenesis/dysgenesis. The prevalence of all types of congenital malformations in children born to mothers with pregestational diabetes (type 1 and type 2) is estimated between 5.0 and 6.1% compared to a 1.3 to 2.8% prevalence in the general population (Moore et al 2000; Sheffield et al 2002; Jeansen et al 2004; Davis et al 2010).