Not all kidneys are born equal – the pitfall of prematurity

Oded Volovelsky, M.D., Ph.D., Moris Nehama, Ph.D. Pediatric Department.

Prematurity is defined as a live birth before 37 weeks of pregnancy are completed. Due to improvements in clinical care and research in this field, the incidence of live premature birth has increased dramatically within the past decades. Every year, an estimated 15 million babies are born prematurely. However, prematurity can lead to an increased rate of adult diseases, when organs such as the kidney have not developed well in utero.

The human nephron, the basic functional unit of the kidney, is a structure that produces urine in the process of removing waste and excess substances from the blood. The creation of human nephrons ceases by the 35th week of gestation; it is estimated that an average of 1,000,000 nephrons are produced in each normal human kidney. However, this number varies greatly between different individuals. Thus, low nephron numbers in premature newborns, or as a result of kidney damage, are an independent risk factor for hypertension and kidney disease in later stages of life, one of the leading diseases in the developed world. At present, little can be done clinically to augment nephron number.

Dr. Oded Volovelsky, a pediatric nephrologist and Dr. Moris Nehama, a Researcher, are undertaking a very important and innovative research, focusing on gaining knowledge on the mechanisms involved in the generation of new nephrons in the kidney and seeking strategies for optimization of nephron number after birth. Regenerative medicine using stem cells is an innovative solution that Dr. Volovelsky and his research team will be using to combat kidney disease due to low numbers of nephrons.

A stem cell is defined as a cell that -upon division- can self-renew and give rise to differentiated cell types. Dr. Volovelsky has identified during his previous research that the decreased activity of a specific gene in the stem cells of the kidney can lead to an increased number of nephrons. This encouraging finding, obtained from research using a mouse model, will be published in the near future in one of the leading peer-reviewed genetic journals.

Dr. Volovelsky’s and Dr. Nehama's innovative research may revolutionize the care of kidney disease. The notion that nephron numbers can be restored with timely intervention in experimental models gives hope to the important struggle to find a cure for kidney diseases.

Dr. Volovelsky and Dr. Nehama have a wonderful record of accomplishment doing research as part of their PhD at Hadassah and then in leading laboratories in the US as part of their postdoctoral work and training. They have recently returned to Hadassah and now join forces to look at kidney disease from a different angle. Their innovative research opens new venues, and may revolutionize the care of kidney disease.