Relationship between maternal global nutrient restriction during pregnancy and offspring kidney structure and function: a systematic review of animal studies

Author:

Lee Yu Qi12ORCID,Beckett Emma L.3,Sculley Dean V.24,Rae Kym M.13567,Collins Clare E.48,Pringle Kirsty G.125

Affiliation:

1. Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, New South Wales, Australia

2. Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia

3. Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia

4. Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, New South Wales, Australia

5. Faculty of Health and Medicine, Gomeroi Gaaynggal Center, University of Newcastle, Tamworth, New South Wales, Australia

6. Department of Rural Health, University of Newcastle, Tamworth, New South Wales, Australia

7. Priority Research Center for Generational Health and Aging, University of Newcastle, Newcastle, New South Wales, Australia

8. Faculty of Health and Medicine, School of Health Sciences, University of Newcastle, Newcastle, New South Wales, Australia

Abstract

Maternal undernutrition during pregnancy is prevalent across the globe, and the origins of many chronic diseases can be traced back to in utero conditions. This systematic review considers the current evidence in animal models regarding the relationship between maternal global nutrient restriction during pregnancy and offspring kidney structure and function. CINAHL, Cochrane, EMBASE, MEDLINE, and Scopus were searched to November 2017. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed, and articles were screened by two independent reviewers. Twenty-eight studies met the inclusion criteria: 16 studies were on rats, 9 on sheep, 2 on baboons, and 1 on goats. The majority of the rat studies had maternal global nutrient restriction during pregnancy at 50% of ad libitum while restriction for sheep and baboon studies ranged from 50% to 75%. Because of the heterogeneity of outcome measures and the large variation in the age of offspring at followup, no meta-analysis was possible. Common outcome measures included kidney weight, nephron number, glomerular size, glomerular filtration rate, and creatinine clearance. To date, there have been no studies assessing kidney function in large animal models. Most studies were rated as having a high or unknown risk of bias. The current body of evidence in animals suggests that exposure to maternal global nutrient restriction during pregnancy has detrimental effects on offspring kidney structure and function, such as lower kidney weight, lower nephron endowment, larger glomerular size, and lower glomerular filtration rate. Further long-term followup of studies in large animal models investigating kidney function through to adulthood are warranted.

Publisher

American Physiological Society

Subject

Physiology

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