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Nephrol Dial Transplant (2002) 17: 45-47
© 2002 European Renal Association-European Dialysis and Transplant Association

Congenital Anomalies of the Kidney and Urinary Tract

Embryogenesis of the congenital anomalies of the kidney and the urinary tract

Fumiyo Kuwayama1, Yoichi Miyazaki2 and Iekuni Ichikawa1,3,4,

1 Department of Pediatrics, Tokai University School of Medicine, Isehara, 2 Department of Medicine, Jikei University School of Medicine, Japan and Departments of 3 Pediatrics and 4 Medicine,Vanderbilt University Medical Center, Nashville, TN, USA

Abstract

Ectopia of the initial ureter is the first ontogenic mis-step that leads to many congenital anomalies of the kidney and urinary tract (CAKUT). The ectopia results in hypoplastic kidney, ectopia of the ureteral orifice, urinary outflow obstruction and/or reflux. Recent studies on several mutant mouse models verified that ectopic ureteral budding indeed occurs prior to the formation of CAKUT. Often, the genes involved in navigating the site of ureteral budding also regulate later ontogenic processes of the kidney and other urinary tract systems. These additional functions of the genes underlie the wide spectrum of CAKUT, as the genes are expressed at multiple sites at multiple ontogenic stages, and regulate the morphogenesis of the many portions of the excretory system through their distinctive cellular functions.

Keywords: angiotensin; BMP4

Notes

Correspondence and offprint requests to: Iekuni Ichikawa, MD, PhD, Vanderbilt University Medical Center, MCN C4204, 21st and Garland Avenue, Nashville, TN 37232-2584, USA.


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