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Developmental programming of the kidney: does sex matter?

The ‘Developmental Origins of Health and Disease’ proposes that early life events may, in part, determine the risk of many chronic diseases in later life. Two key features of this concept that are highlighted in a recent study by Moritz et al. (Moritz et al. 2009) in The Journal of Physiology are the existence of critical windows of susceptibility and the different adaptive responses to developmental insults observed between male and female offspring (Gilbert & Nijland, 2008). Depending upon the species studied, critical windows of sensitivity have been identified from conception through the neonatal period. This is particularly relevant with respect to the programming of cardiorenal function, as renal development extends into the postnatal period in laboratory species, such as the rat. Hence, it is important to recognize that it is not only the fetus that may be at risk for developmental programming but also the neonate. Moreover, recent studies have shown that the extent to which an insult may affect the offspring also depends upon the sex of the fetus/neonate (Zambrano et al. 2005). Nevertheless, the manner in which critical windows of susceptibility and sex differences interact to result in developmental programming remains unclear.