Low birth weight and its implication in renal disease.

It has been demonstrated that intrauterine growth retardation, defined as birth weight below the 10th percentile, gives rise to a reduction in nephron number. Oligonephropathy has been suggested to increase the risk for systemic and glomerular hypertension in adult life as well as enhance risk for expression of renal disease after exposure to potentially injurious renal stimuli. Diseases, such as diabetes, that damage the kidney, may enhance this risk. In addition, it has been hypothesized that the same factors affecting kidneys in utero also impact on pancreatic tissue development, thus predisposing infants of low birth weight to an increased risk for the subsequent development of diabetes and diabetic nephropathy, consistent with the so-called "thrifty phenotype" hypothesis. Impact of low birth weight on nondiabetic renal disease has also been shown in some studies. In the current scenario, chronic kidney disease is increasing all over the world and the major two causes are diabetes and hypertension. Once the issues are shifting from management of end-stage renal disease to prevention of chronic kidney disease, prevention of low birth weight is likely to be an issue for the nephrologists in future.