Pediatric Urology: Contemporary Strategies from Fetal Life to Adolescence

The embryological development of the urogenital system, wich includes two embryologically and anatomically interconnetted units, the urinary tract and genital tract, has been well understood from decades. Only in the last few years, a significant amount of data on the genetic regualtion of these developmental processes has been produced, largely through studies of mutant mouse models and growing number of mutant mouse and a growing number of human studies. Among the most recent concepts the nephron endowement is of particular interest for its significance in the relationship between the effects of changes in fetal microenvironment on renal development on one hand and the risk of renal and cardiovascular disease in the adulthood on the other. Infact adverse events during fetal life may predispose an individual to increased cardiovascular risk in adulthood, establishing what is referred to by many researchers as "fetal programming" of adult cardiovascular disease. Indeed current literatur reflects a growing interest on the relationship between the reduced number of nephron at birth and the consequences in entails in term of cardiovascular risk. In the human species, the number of nephron at birth is extremelly variable, mirroring the extreme variability of the development of the kidney and urinary tract and different effectiveness in responding to the challenges of post-natal life.