DEVELOPMENT: renal development Flashcards by Grace Johnson

Early development of renal system starts at?

Day 21

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Direction of early renal development

Cranial to caudal

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Renal system forms from?

Intermediate mesoderm

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Stages of renal development

Paired pronephros

Paired mesonephros

Paired metanephros

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Which stage if development is non functional in human

Paired pronephros

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Which stage in renal development forms tubules and is briefly functional. Degenerates from week 8 (make stain part of the duct in reproductive development)?

Paired mesonephros - weeks 5-11

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Which stage of renal development forms from a branch of the mesonephros and is permanent in kidney. It also drains into the Cloaca

Paired metanephros

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When do the first excretory tubules of mesonephros appear and the non-functional pronephros degenerates?

End of week 4 (after fertilisation)

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The ureteri bud form as a branch at what end?

Caudal end

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The mesonephric tissue and duct run along the embrioni in what direction?

Cranial-caudal direction

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The gonadal tissue sits alongside the mesonephros AR the more caudal end forming the?

Urogenital ridge

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Excretory tubules lengthen rapidly and join the duct(B)
Form S-shaped loops (C)
A tuft of capillaries form at the medial end of vasculature (D) to form the glomeruli
Tubules form the Bowman’s capsule around the glomeruli (D)
Laterally, the tubules enter the mesonephric duct

These are stages of what?

Tubule formation

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A. Duct forms and a vesicle is created within the mesonephros.

B. Vesicle grows to forms tubule

C. S-shaped loop

D. Tubule joins duct at one end and forms a capsule around the glomerulus (blood supply)

E. Relationship with genital ridge

These are steps of ?

Development of tubules

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The paramesoneprhic ducts forms by?

Invagination of tissue associated with FGF expression

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What causes the invagination of tissue to form the paramesonephric duct?

FGF expression

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What is the permanent or ‘true’ kidney?

Metanephros

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The metanephros appears when?

5th week after fertilisation

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When does the metanephron produce fluid ?

9th week after fertilisation

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What is fully functional after birth in producing urine?

Metanephros

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What structure handles the functions of the kidney in the fetus?

Placenta

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Metanephros is formed by?

Metaneohric blastema & uteric bud from mesonephros

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Nephrons are formed from?

Metanephric blastema

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Collecting ducts, renak oelvix and ureter are all formed from the?

Uteric bud from mesonephros

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What is involved in the differentiation of the uteric bud from mesonephros to form collecting duct, renal pelvis and ureters?

Wilm’s tumour 1

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Collecting ducts, renal pelvis and ureters are structured of the?

Collecting system

Structures in order of formation

1. Pronephros 2. Mesonephros 3. Metanephros

How is a functional kidney formed?

The excretory unit and the collecting system fuse together

Postnatal hypertension - Hugson

Low nephron number

The ureteric bud dilates and eventually forms?

- ureter - renal pelvis - major and minor calyces - collecting ducts and 1-3 million tubules (which form the pyramids)

Kidney becomes function al ?

12 weeks

Urine is released into the ......., swallowed and recycled through the .........

Amnion Kidneys

Waste is removed by the?

Placenta NOT KIDNEY

Process of formation of the collecting system is called?

Branching morphogenesis

What process is key to the formation of the kidney, lungs, mammary glands , salivary glands as well as vascular ire and neural growth ?

Branching morphogenesis

What promoted budding during ureteric bud and metanephric mesenchyme interactions?

WT 1 and GDNF

Bud induces condensations of cells, which become ?

Endothelial- Mesenchymal Endothelial Transition MET

Movement of the kidneys as the fetus straightens and elongates- carries the kidney from........ to

The pelvis A more cranial position

Kidneys develop ?

Caudally , but will move further up (cranially)

During the shift (the ascent of the kidneys), blood supply changes. Initially they are supplied by the .......... then later from the .......

Branches from the common iliac artery Aorta

What happens NORMALLY to the more caudal vessels?

Degenerate

What may occur is degeneration of more caudal vessels does not occur?

Supernumerary renal arteries

Development of the bladder

●Cloaca originally joins the GI and urogenital tracts. ●Urorectal septum divides it to create the perineal body ●Division also allows the formation of the urogenital sinus and bladder

During the development of the bladder, The cloaca originally joins?

GI and urogenital tracts

During development of the bladder, urorectal septum divides the union of GI and urogenital tracts to create the!

Perineal body

Division if the GI tract and urogenital tracts by urorectal septum allows the formation of the?

Urogenital sinus and bladder

During weeks 4 to 7 cloaca divides to form?

Urogenital sinus - anterior Anal canal - posterior

Balder and urethra develop from

Urogenital sinus

The urogenital sinus develops into several structures:

1. Cranial part becomes the urinary bladder 2. Pelvic part of the membranous & prostatic urethra 3. Definitive urogenital sinus

Caudal part of the urogenital sinus develops into the?

Penile urethra

By the end of the 3rd month, the epithelium of the prostatic urethra proliferates to form ?

Outgrowths into the surrounding mesoderm

In females, the urethra gives rise to the ?

Urethral & paraurethral glands

In males thE outgrowths into the surrounding mesoderm form the ?

Prostate gland

During formation of the cloaca, the caudal mesonephric ducts join the ?

Bladder

At first the ureteric bud is an .........., but they eventually separate

Outgrowth

As the fetus grows the ureters are carried cranial and the mesonephric ducts move closer and become the?

Male ejaculatory ducts

Newborn kidney does not function at adult levels until approximately? Consequences?

2 years of age Affects ability to excrete drugs and maintain fluid balance

The thin descending limb does not reach its final length until ?

After birth

Premature babies can’t reabsorb Na2+ as?

Glomerular Filtration Rate is linked to catecholamine production.

Babies can’t get rid of excess water load as they have?

Delayed excretionrates - low GFR , low renal Blood flow

- Loss of Na 2+ , increase in extracellular fluid or excess water - Premature babies can’t reabsorb Na2+ as Glomerular Filtration Rate is linked to catecholamine production. - Premature babies have low catecholamine production - Babies can’t get rid of excess water load as they have delayed excretion rates(low GFR), low renal blood flow Are symptoms of

Hyponatremia, 15% of babies

Dangers of hyponatremia

●Cell swelling ●Brain injury from swelling ●Demyelination and brain damage: permanent effects if untreated

GFR (Glomerular filtration)does not increase to adult levels until approximately ?

2 years of age

Babies are less sensitive to ADH. Water is not reabsorbed. This can also to?

Hyponatremia

High diuresis in first few days. Stabilises by ?

5 days

Congenital disorders ie cardiac problems, adrenal hyperplasia , diaphragmatic herniation will affect normal neonatal renal physiology, so it is important to measure urine output. Normal range of urine output ?

2 ml/kg/day

●Affects fetus and/or children <5 ●80-85 children per year ●Renal Cancer (nephroblastoma) ●Treatment usually successful ●Bilateral tumours are rare, so patients are left with one functioning kidney ●Associated with other congenital symptoms: aniridia, hemihyperplasia and other genitourinary disorders ●Overgrowth of mesodermal tissue ●Associated with the gene Wilm’s Tumour 1 (WT1) Are symptoms of?

Wilm’s tumour

Amniotic fluid is produced by

Amnioblasts- cells lining the amniotic cavity, lungs, and is in circulation across the placenta

The embryo and fetus swallows this fluid and a corresponding amount of fluid is ‘excreted’ via the kidneys, name the process

This fluid= amniotic fluid Process= amniotic circulation

Most waste products of the fetus are handled by the mother via the?

Placenta

Volume of amniotic fluid normally rises to about ......... at 34 weeks of pregnancy and decreases ...... at term

800 mls 600 mls

These symptoms are related to what amniotic circulation problem? ●excess amniotic fluid (>25 cm total depth on 4 ultrasound measurements) ●Blockage of oesophagus or upper gut ●If there is something wrong with the fluid excretion (blocked urethra, kidneys not functioning) there will be a deficiency of amniotic fluid

Polyhydramnios

These symptoms are related to what amniotic fluid circulation problem? - too little amniotic fluid(<5 cm total depth on 4 ultrasound measurements) - Blockage of urethra or absent/non-functioning kidneys

Oligohydramnios

Problems with renal system are caused by?

Early degeneration of ureteric bud Movement of kidney position and attachments of blood vessels

Bilateral renal a genesis is?

Absence of one kidney ●Rare ●Genetic in origin ●Associated with oligohydramnios ●Incompatible with postnatal life ●Transplants may be possible, but difficult to obtain donor kidneys ●Unilateral agenesis is compatible with life

Failed closure of the urethra. Often considered with genital differences. MSK defect

Hypospadias

Failure of kidney to migrate cranially,

Pelvic kidney

Failure to migrate cranially AND fusion of lower portion

Horseshoe kidney