Pediatric Nephrology - What’s New in Renal Development: a topical collection
Our understanding of renal development is expanding rapidly, driven by advances in basic developmental biology, stem cell research and regenerative medicine, as well as improved understanding of nephron growth and maturation towards the end of gestation. A significant proportion of childhood kidney disease is genetic in origin, and mutations in a growing number of genes are implicated in various disease mechanisms, particularly in renal development. Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) are the most common cause of childhood chronic kidney disease, and while genetic mutations are often suspected, the specific mutations in many cases are currently unknown. Research using model organisms and in vitro cell approaches have given insights into the early stages of kidney patterning and nephron formation, identifying key genes and signalling pathways. The progression of stem cell and renal organoid research are incrementally reducing the knowledge gap between early and late stages of kidney development, identifying factors leading to differentiation of specific cell lineages and maturation. After the initial stages of kidney development, improved perinatal care is improving survival rates at earlier gestational ages, allowing the effects of prematurity to be studied before the completion of nephrogenesis around 34-36 weeks. How premature birth affects kidney size and function with subsequent risks of chronic kidney disease, hypertension and proteinuria later in life, demonstrate the need for long-term follow up in specific populations. This Topical Collection brings together the latest reviews and articles on kidney development, and how disruption, either in the developmental process or in gestation, may result in impaired renal function. Advances in this field could accelerate the rate of diagnosis for various forms of genetic kidney disease and the development of new treatments, as well as highlighting risk areas for future research.