Understanding the Role of Maternal Diet on Kidney Development; an Opportunity to Improve Cardiovascular and Renal Health for Future Generations

Abstract

The leading causes of mortality and morbidity worldwide are cardiovascular disease (high blood pressure, high cholesterol and renal disease), cancer and diabetes. It is increasingly obvious that the development of these diseases encompasses complex interactions between adult lifestyle and genetic predisposition. Maternal malnutrition can influence the fetal and early life environment and pose a risk factor for the future development of adult diseases, most likely due to impaired organogenesis in the developing offspring. This then predisposes these offspring to cardiovascular disease and renal dysfunction in adulthood. Studies in experimental animals have further illustrated the significant impact maternal diet has on offspring health. Many studies report changes in kidney structure (a reduction in the number of nephrons in the kidney) in offspring of protein-deprived dams. Although the early studies suggested that increased blood pressure was also present in offspring of protein-restricted dams, this is not a universal finding and requires clarification. Importantly, to date, the literature offers little to no understanding of when in development these changes in kidney development occur, nor are the cellular and molecular mechanisms that drive these changes well characterised. Moreover, the mechanisms linking maternal nutrition and a suboptimal renal phenotype in offspring are yet to be discerned—one potential mechanism involves epigenetics. This review will focus on recent information on potential mechanisms by which maternal nutrition (focusing on malnutrition due to protein restriction, micronutrient restriction and excessive fat intake) influences kidney development and thereby function in later life.

Maternal Low Quality Protein Diet Alters Plasma Amino Acid Concentrations of Weaning Rats

“…There is a large body of evidence indicating that birth weight can be a potential predictor of programming effects in animal models [ 38 , 39 ]. Some studies reported a decreased birth weight following maternal low quality protein diets [ 40 , 41 ] whereas a different study showed no effect of 21% wheat gluten [ 42 ].…”

Nutritional Challenges in Pregnant Women with Renal Diseases: Relevance to Fetal Outcomes

“…In particular, maternal nutritional status plays a critical role in the fetus health [13]. Indeed, a diet containing sufficient amounts of macro-and micronutrients is essential to fetus organogenesis, whereas adverse nutritional conditions during pregnancy may permanently change the structure and function of specific organs, exposing the offspring also to the risk to develop adult diseases [14]. The difficulty to provide the correct nutrition in pregnant women is further complicated in CKD patients, in whom nutritional therapy is a cornerstone of the clinical management of renal diseases [15].…”

Sex and the preimplantation embryo: implications of sexual dimorphism in the preimplantation period for maternal programming of embryonic development

“…In species as diverse as amphibians (Berg et al 2009), reptiles (Schwanz et al 2013), teleosts (Meier et al 2010; Celeghin et al 2011), and mammals (Roseboom et al, 2001; Walker et al, 2012; Ganu et al, 2012; Fleming et al, 2015), alterations in embryonic environment can have long-acting effects on development that extend into post-natal life. Mechanisms responsible for this phenomenon include changes in the epigenome (El-Hajj et al 2014; Desai et al 2015) as well as in patterns of organogenesis and differentiation (Fleming et al, 2015; Wood-Bradley et al, 2015). Developmental programming can be beneficial when the deviation in adult phenotype prepares the individual for life in the anticipated postnatal environment but can be harmful when the actual environment is different than expected (Roseboom et al 2001; Armitage et al 2005; Gluckman et al 2007; Warner 2014).…”