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Review
. 2025 Aug;72(1):143-156.
doi: 10.1016/j.yapd.2025.03.004. Epub 2025 May 22.

Renal Physiology: From Fetus to Newborn and Beyond

Benjamin Holland  1 , Cara L Slagle  2 , Michelle C Starr  3
Affiliations
Review

Renal Physiology: From Fetus to Newborn and Beyond

Benjamin Holland et al. Adv Pediatr. 2025 Aug.

Abstract

Developmental renal physiology concepts can best be divided into prenatal, perinatal, and postnatal periods. Structural kidney development and a maximum number of nephron formations predominate the prenatal period with kidney function playing a primary role in amniotic fluid production. Kidney function reaches near-adult maturation around 2 y of age, with variation depending on gestational age at birth and neonatal complications. Neonatal kidneys are particularly sensitive to injury, which impacts both short- and long-term health outcomes. A greater understanding of developmental renal physiology facilitates increased awareness of kidney health, thus improving overall care.

Keywords: Glomerular filtration rate; Kidney; Neonate; Preterm; Renal physiology; Urine output.

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Conflict of interest statement

Disclosures All authors report no real or perceived conflicts of interest that could affect the study design, collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the article for publication. For full disclosure, we provide an additional list of authors’ other funding not directly related to this article. M. Starr is supported in part by the Indiana University School of Medicine Physician Scientist Initiative and K23HL168362. B. Holland was supported by the IMPRS program and the Indiana Clinical and Translational Sciences Institute, United States funded, through an award made by the National Center for Advancing Translational Sciences of the National Institutes of Health, under the award number UL1TR00252. The authors have nothing to disclose.

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