The Fate of Nephrons in Congenital Obstructive Nephropathy: Adult Recovery is Limited by Nephron Number

Background: Pediatric chronic kidney disease (CKD) is most often due to congenital anomalies of the kidneys and urinary tract (CAKUT), and obstructive nephropathy is the leading cause. Progression to renal failure, however, is more likely to develop in adulthood than childhood (Wuhl, CJASN 8: 67–74, 2013). Frequently associated with CAKUT, reduced nephron number (NN) at birth is an independent risk factor for adult CKD. Methods: To determine the role of NN in progression of congenital obstructive nephropathy, wild-type (WT) and reduced NN mice (Os/+) were subjected to sham operation or partial unilateral ureteral obstruction (UUO) in the first 2 days of life (prior to completion of nephroge…