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Updated: Mar 17 2022

Kidney Embryology

  • Overview
    • Kidney development
      • progresses in a cranial to caudal direction
      • intermediate mesoderm → urogenital ridge → nephrogenic cord → urinary system
    • Pronephros
      • non-functional
      • appears by week 4
      • degenerates by week 5
    • Mesonephros
      • development induced by pronephric duct
      • forms mesonephric duct (Wolffian duct)
      • interim kidney for 1st trimester
      • opens into urogenital system and gives rise to male genital system
    • Metanephros
      • develops from mesonephric outgrowth called ureteric bud during week 5
      • fully canalized and functioning at week 10
      • nephrogenesis continues through 32 - 36 weeks of gestation
      • derivatives include
        • ureteric bud develops into
          • ureter
          • pelvises
          • calyces and collecting ducts
          • aberrant development may result in congenital malformations of the lower urinary tract
        • metanephric mesenchyme
          • interaction with ureteric bud causes metranephric mesenchyme to differentiate the renal structures from collecting tubules to glomerulus
          • abnormal interaction with ureteric bud may cause malformations
    • Ureteropelvic junction with kidney
      • canalizes last
      • most common site of obstruction in fetuswhich results inhydronephrosis
    • Adult kidney
      • embryo grows faster caudally causing a change in location of the kidney from S1 - S2 to a final position of T12 - L3
  • Developmental Abnormalities
    • Renal agenesis
      • failure of ureteric buds to form → no kidney formation
    • Potter's Syndrome
      • bilateral renal agenesis →oligohydramnios →fetal compression resulting in
        • limb deformities
          • clubbed feet
        • facial deformities
        • pulmonary hypoplasia
    • Horseshoe kidney
      • fusion of inferior poles ofkidneys
        • ascension of kidney is prevented by the inferior mesenteric artery
        • fused kidneys remain low in abdomen and may cause other renal vascular anomalies.
        • normal kidney function
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