Abstract
Vesicoureteric reflux (VUR) is a common congenital urinary tract defect that predisposes children to recurrent kidney infections. Kidney infections can result in renal scarring or reflux nephropathy defined by the presence of chronic tubulo-interstitial inflammation and fibrosis that is a frequent cause of end-stage renal failure. The discovery of mouse models with VUR and with reflux nephropathy has provided new opportunities to understand the pathogenesis of these conditions and may provide insight on the genes and the associated phenotypes that need to be examined in human studies.
Similar content being viewed by others
References
Williams G, Fletcher JT, Alexander SI, Craig JC (2008) Vesicoureteral reflux. J Am Soc Nephrol 19:847–862
Greenbaum LA, Mesrobian HG (2006) Vesicoureteral reflux. Pediatr Clin N Am 53:413–427, vi
Darge K (2002) Diagnosis of vesicoureteral reflux with ultrasonography. Pediatr Nephrol 17:52–60
Canadian Organ Replacement Register (CORR) (2011) CORR annual report—treatment of end-stage organ failure in Canada, 2000 to 2009. Available at: http://securecihica/free_products/2011_CORR_Annual_Report_final_epdf
North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS) (2011) NAPRTCS annual report, 2011. Available at: http://webemmescom/study/ped/annlrept/annualrept2011pdf
Craig JC, Irwig LM, Knight JF, Roy LP (2000) Does treatment of vesicoureteric reflux in childhood prevent end-stage renal disease attributable to reflux nephropathy? Pediatrics 105:1236–1241
Schreuder MF, Nauta J (2007) Prenatal programming of nephron number and blood pressure. Kidney Int 72:265–268
Saxen L (1987) Organogenesis of the kidney. Cambridge University Press, Cambridge
Murawski IJ, Myburgh DB, Favor J, Gupta IR (2007) Vesico-ureteric reflux and urinary tract development in the Pax21Neu+/− mouse. Am J Physiol Ren Physiol 293:F1736–F1745
Costantini F (2012) Genetic controls and cellular behaviors in branching morphogenesis of the renal collecting system. Wiley Interdisc Rev Dev Biol 1:693–713
Bouchard M (2004) Transcriptional control of kidney development. Differentiation 72:295–306
Majumdar A, Vainio S, Kispert A, McMahon J, McMahon AP (2003) Wnt11 and Ret/Gdnf pathways cooperate in regulating ureteric branching during metanephric kidney development. Development 130:3175–3185
Hains D, Sims-Lucas S, Kish K, Saha M, McHugh K, Bates CM (2008) Role of fibroblast growth factor receptor 2 in kidney mesenchyme. Pediatr Res 64:592–598
Basson MA, Akbulut S, Watson-Johnson J, Simon R, Carroll TJ, Shakya R, Gross I, Martin GR, Lufkin T, McMahon AP, Wilson PD, Costantini FD, Mason IJ, Licht JD (2005) Sprouty1 is a critical regulator of GDNF/RET-mediated kidney induction. Dev Cell 8:229–239
Kume T, Deng K, Hogan BL (2000) Murine forkhead/winged helix genes Foxc1 (Mf1) and Foxc2 (Mfh1) are required for the early organogenesis of the kidney and urinary tract. Development 127:1387–1395
Grieshammer U, Le M, Plump AS, Wang F, Tessier-Lavigne M, Martin GR (2004) SLIT2-mediated ROBO2 signaling restricts kidney induction to a single site. Dev Cell 6:709–717
Puri P, Gosemann JH, Darlow J, Barton DE (2011) Genetics of vesicoureteral reflux. Nat Rev Urol 8:539–552
Mackie GG, Stephens FD (1975) Duplex kidneys: a correlation of renal dysplasia with position of the ureteral orifice. J Urol 114:274–280
Pope JC, Brock JW 3rd, Adams MC, Stephens FD, Ichikawa I (1999) How they begin and how they end: classic and new theories for the development and deterioration of congenital anomalies of the kidney and urinary tract, CAKUT. J Am Soc Nephrol 10:2018–2028
Murawski IJ, Watt CL, Gupta IR (2011) Vesico-ureteric reflux: using mouse models to understand a common congenital urinary tract defect. Pediatr Nephrol 26:1513–1522
Aoki Y, Mori S, Kitajima K, Yokoyama O, Kanamaru H, Okada K, Yokota Y (2004) Id2 haploinsufficiency in mice leads to congenital hydronephrosis resembling that in humans. Genes Cells 9:1287–1296
Chang CP, McDill BW, Neilson JR, Joist HE, Epstein JA, Crabtree GR, Chen F (2004) Calcineurin is required in urinary tract mesenchyme for the development of the pyeloureteral peristaltic machinery. J Clin Invest 113:1051–1058
Yu J, Carroll TJ, McMahon AP (2002) Sonic hedgehog regulates proliferation and differentiation of mesenchymal cells in the mouse metanephric kidney. Development 129:5301–5312
Iizuka-Kogo A, Ishidao T, Akiyama T, Senda T (2007) Abnormal development of urogenital organs in Dlgh1-deficient mice. Development 134:1799–1807
Airik R, Trowe MO, Foik A, Farin HF, Petry M, Schuster-Gossler K, Schweizer M, Scherer G, Kist R, Kispert A (2010) Hydroureternephrosis due to loss of Sox9-regulated smooth muscle cell differentiation of the ureteric mesenchyme. Hum Mol Genet 19:4918–4929
Caubit X, Lye CM, Martin E, Core N, Long DA, Vola C, Jenkins D, Garratt AN, Skaer H, Woolf AS, Fasano L (2008) Teashirt 3 is necessary for ureteral smooth muscle differentiation downstream of SHH and BMP4. Development 135:3301–3310
Brenner-Anantharam A, Cebrian C, Guillaume R, Hurtado R, Sun TT, Herzlinger D (2007) Tailbud-derived mesenchyme promotes urinary tract segmentation via BMP4 signaling. Development 134:1967–1975
Trowe MO, Airik R, Weiss AC, Farin HF, Foik AB, Bettenhausen E, Schuster-Gossler K, Taketo MM, Kispert A (2012) Canonical Wnt signaling regulates smooth muscle precursor development in the mouse ureter. Development 139:3099–3108
Bohnenpoll T, Bettenhausen E, Weiss AC, Foik AB, Trowe MO, Blank P, Airik R, Kispert A (2013) Tbx18 expression demarcates multipotent precursor populations in the developing urogenital system but is exclusively required within the ureteric mesenchymal lineage to suppress a renal stromal fate. Dev Biol 380:25–36
Airik R, Bussen M, Singh MK, Petry M, Kispert A (2006) Tbx18 regulates the development of the ureteral mesenchyme. J Clin Invest 116:663–674
Hurtado R, Bub G, Herzlinger D (2010) The pelvis-kidney junction contains HCN3, a hyperpolarization-activated cation channel that triggers ureter peristalsis. Kidney Int 77:500–508
Uetani N, Bertozzi K, Chagnon MJ, Hendriks W, Tremblay ML, Bouchard M (2009) Maturation of ureter-bladder connection in mice is controlled by LAR family receptor protein tyrosine phosphatases. J Clin Invest 119:924–935
Batourina E, Tsai S, Lambert S, Sprenkle P, Viana R, Dutta S, Hensle T, Wang F, Niederreither K, McMahon AP, Carroll TJ, Mendelsohn CL (2005) Apoptosis induced by vitamin A signaling is crucial for connecting the ureters to the bladder. Nat Genet 37:1082–1089
Chia I, Grote D, Marcotte M, Batourina E, Mendelsohn C, Bouchard M (2011) Nephric duct insertion is a crucial step in urinary tract maturation that is regulated by a Gata3-Raldh2-Ret molecular network in mice. Development 138:2089–2097
Viana R, Batourina E, Huang H, Dressler GR, Kobayashi A, Behringer RR, Shapiro E, Hensle T, Lambert S, Mendelsohn C (2007) The development of the bladder trigone, the center of the anti-reflux mechanism. Development 134:3763–3769
Tanagho EA, Pugh RC (1963) The anatomy and function of the ureterovesical junction. Br J Urol 35:151–165
Kaefer M, Curran M, Treves ST, Bauer S, Hendren WH, Peters CA, Atala A, Diamond D, Retik A (2000) Sibling vesicoureteral reflux in multiple gestation births. Pediatrics 105:800–804
Muroya K, Hasegawa T, Ito Y, Nagai T, Isotani H, Iwata Y, Yamamoto K, Fujimoto S, Seishu S, Fukushima Y, Hasegawa Y, Ogata T (2001) GATA3 abnormalities and the phenotypic spectrum of HDR syndrome. J Med Genet 38:374–380
Nishimura H, Yerkes E, Hohenfellner K, Miyazaki Y, Ma J, Hunley TE, Yoshida H, Ichiki T, Threadgill D, Phillips JA 3rd, Hogan BM, Fogo A, Brock JW 3rd, Inagami T, Ichikawa I (1999) Role of the angiotensin type 2 receptor gene in congenital anomalies of the kidney and urinary tract, CAKUT, of mice and men. Mol Cell 3:1–10
Yang Y, Letendre J, Houle A, Richter A (2008) RET Gly691Ser mutation is associated with primary vesicoureteral reflux in the French-Canadian population from Quebec. Hum Mutat 29:695–702
Sanyanusin P, Schimmenti LA, McNoe LA, Ward TA, Pierpont ME, Sullivan MJ, Dobyns WB, Eccles MR (1995) Mutation of the PAX2 gene in a family with optic nerve colobomas, renal anomalies and vesicoureteral reflux. Nat Genet 9:358–364
Jenkins D, Bitner-Glindzicz M, Malcolm S, Hu CC, Allison J, Winyard PJ, Gullett AM, Thomas DF, Belk RA, Feather SA, Sun TT, Woolf AS (2005) De novo uroplakin 111a heterozygous mutations cause renal adysplasia leading to severe kidney failure. J Am Soc Nephrol 16:2141–2149
Jenkins D, Bitner-Glindzicz M, Malcolm S, Allison J, de Bruyn R, Flanagan S, Thomas DF, Belk RA, Feather SA, Bingham C, Southgate J, Woolf AS (2006) Mutation analyses of Uroplakin II in children with renal tract malformations. Nephrol Dial Transplant 21:3415–3421
Mackintosh P, Almarhoos G, Heath DA (1989) HLA linkage with familial vesicoureteral reflux and familial pelvi-ureteric junction obstruction. Tissue Antigens 34:185–189
Rigoli L, Chimenz R, di Bella C, Cavallaro E, Caruso R, Briuglia S, Fede C, Salpietro CD (2004) Angiotensin-converting enzyme and angiotensin type 2 receptor gene genotype distributions in Italian children with congenital uropathies. Pediatr Res 56:988–993
Yim HE, Bae IS, Yoo KH, Hong YS, Lee JW (2007) Genetic control of VEGF and TGF-beta1 gene polymorphisms in childhood urinary tract infection and vesicoureteral reflux. Pediatr Res 62:183–187
Lu W, van Eerde AM, Fan X, Quintero-Rivera F, Kulkarni S, Ferguson H, Kim HG, Fan Y, Xi Q, Li QG, Sanlaville D, Andrews W, Sundaresan V, Bi W, Yan J, Giltay JC, Wijmenga C, de Jong TP, Feather SA, Woolf AS, Rao Y, Lupski JR, Eccles MR, Quade BJ, Gusella JF, Morton CC, Maas RL (2007) Disruption of ROBO2 is associated with urinary tract anomalies and confers risk of vesicoureteral reflux. Am J Hum Genet 80:616–632
Bertoli-Avella AM, Conte ML, Punzo F, de Graaf BM, Lama G, La Manna A, Polito C, Grassia C, Nobili B, Rambaldi PF, Oostra BA, Perrotta S (2008) ROBO2 gene variants are associated with familial vesicoureteral reflux. J Am Soc Nephrol 19:825–831
Dobson MG, Darlow JM, Hunziker M, Green AJ, Barton DE, Puri P (2013) Heterozygous non-synonymous ROBO2 variants are unlikely to be sufficient to cause familial vesicoureteric reflux. Kidney Int 84:327–337
Gimelli S, Caridi G, Beri S, McCracken K, Bocciardi R, Zordan P, Dagnino M, Fiorio P, Murer L, Benetti E, Zuffardi O, Giorda R, Wells JM, Gimelli G, Ghiggeri GM (2010) Mutations in SOX17 are associated with congenital anomalies of the kidney and the urinary tract. Hum Mutat 31:1352–1359
Sanna-Cherchi S, Sampogna RV, Papeta N, Burgess KE, Nees SN, Perry BJ, Choi M, Bodria M, Liu Y, Weng PL, Lozanovski VJ, Verbitsky M, Lugani F, Sterken R, Paragas N, Caridi G, Carrea A, Dagnino M, Materna-Kiryluk A, Santamaria G, Murtas C, Ristoska-Bojkovska N, Izzi C, Kacak N, Bianco B, Giberti S, Gigante M, Piaggio G, Gesualdo L, Kosuljandic Vukic D, Vukojevic K, Saraga-Babic M, Saraga M, Gucev Z, Allegri L, Latos-Bielenska A, Casu D, State M, Scolari F, Ravazzolo R, Kiryluk K, Al-Awqati Q, D’Agati VD, Drummond IA, Tasic V, Lifton RP, Ghiggeri GM, Gharavi AG (2013) Mutations in DSTYK and dominant urinary tract malformations. N Engl J Med 369:621–629
Weng PL, Sanna-Cherchi S, Hensle T, Shapiro E, Werzberger A, Caridi G, Izzi C, Konka A, Reese AC, Cheng R, Werzberger S, Schlussel RN, Burk RD, Lee JH, Ravazzolo R, Scolari F, Ghiggeri GM, Glassberg K, Gharavi AG (2009) A recessive gene for primary vesicoureteral reflux maps to chromosome 12p11-q13. J Am Soc Nephrol 20:1633–1640
van Eerde AM, Duran K, van Riel E, de Kovel CG, Koeleman BP, Knoers NV, Renkema KY, van der Horst HJ, Bokenkamp A, van Hagen JM, van den Berg LH, Wolffenbuttel KP, van den Hoek J, Feitz WF, de Jong TP, Giltay JC, Wijmenga C (2012) Genes in the ureteric budding pathway: association study on vesico-ureteral reflux patients. PloS One 7:e31327
Feather SA, Malcolm S, Woolf AS, Wright V, Blaydon D, Reid CJ, Flinter FA, Proesmans W, Devriendt K, Carter J, Warwicker P, Goodship TH, Goodship JA (2000) Primary, nonsyndromic vesicoureteric reflux and its nephropathy is genetically heterogeneous, with a locus on chromosome 1. Am J Hum Genet 66:1420–1425
Cordell HJ, Darlay R, Charoen P, Stewart A, Gullett AM, Lambert HJ, Malcolm S, Feather SA, Goodship TH, Woolf AS, Kenda RB, Goodship JA (2010) Whole-genome linkage and association scan in primary, nonsyndromic vesicoureteric reflux. J Am Soc Nephrol 21:113–123
van Eerde AM, Koeleman BP, van de Kamp JM, de Jong TP, Wijmenga C, Giltay JC (2007) Linkage study of 14 candidate genes and loci in four large Dutch families with vesico-ureteral reflux. Pediatr Nephrol 22:1129–1133
Conte ML, Bertoli-Avella AM, de Graaf BM, Punzo F, Lama G, La Manna A, Grassia C, Rambaldi PF, Oostra BA, Perrotta S (2008) A genome search for primary vesicoureteral reflux shows further evidence for genetic heterogeneity. Pediatr Nephrol 23:587–595
Sanna-Cherchi S, Reese A, Hensle T, Caridi G, Izzi C, Kim YY, Konka A, Murer L, Scolari F, Ravazzolo R, Ghiggeri GM, Gharavi AG (2005) Familial vesicoureteral reflux: testing replication of linkage in seven new multigenerational kindreds. J Am Soc Nephrol 16:1781–1787
Murawski IJ, Maina RW, Malo D, Guay-Woodford LM, Gros P, Fujiwara M, Morgan K, Gupta IR (2010) The C3H/HeJ inbred mouse is a model of vesico-ureteric reflux with a susceptibility locus on chromosome 12. Kidney Int 78:269–278
Murawski IJ, Watt CL, Gupta IR (2012) Assessing urinary tract defects in mice: methods to detect the presence of vesicoureteric reflux and urinary tract obstruction. Methods Mol Biol 886:351–362
Srinivas S, Wu Z, Chen CM, D’Agati V, Costantini F (1999) Dominant effects of RET receptor misexpression and ligand-independent RET signaling on ureteric bud development. Development 126:1375–1386
Yu OH, Murawski IJ, Myburgh DB, Gupta IR (2004) Overexpression of RET leads to vesicoureteric reflux in mice. Am J Physiol Ren Physiol 287:F1123–F1130
Dressler GR, Deutsch U, Chowdhury K, Nornes HO, Gruss P (1990) Pax2, a new murine paired-box-containing gene and its expression in the developing excretory system. Development 109:787–795
Bower M, Salomon R, Allanson J, Antignac C, Benedicenti F, Benetti E, Binenbaum G, Jensen UB, Cochat P, DeCramer S, Dixon J, Drouin R, Falk MJ, Feret H, Gise R, Hunter A, Johnson K, Kumar R, Lavocat MP, Martin L, Moriniere V, Mowat D, Murer L, Nguyen HT, Peretz-Amit G, Pierce E, Place E, Rodig N, Salerno A, Sastry S, Sato T, Sayer JA, Schaafsma GC, Shoemaker L, Stockton DW, Tan WH, Tenconi R, Vanhille P, Vats A, Wang X, Warman B, Weleber RG, White SM, Wilson-Brackett C, Zand DJ, Eccles M, Schimmenti LA, Heidet L (2012) Update of PAX2 mutations in renal coloboma syndrome and establishment of a locus-specific database. Hum Mutat 33:457–466
Favor J, Sandulache R, Neuhauser-Klaus A, Pretsch W, Chatterjee B, Senft E, Wurst W, Blanquet V, Grimes P, Sporle R, Schughart K (1996) The mouse Pax2(1Neu) mutation is identical to a human PAX2 mutation in a family with renal-coloboma syndrome and results in developmental defects of the brain, ear, eye, and kidney. Proc Natl Acad Sci USA 93:13870–13875
Hains DS, Sims-Lucas S, Carpenter A, Saha M, Murawski I, Kish K, Gupta I, McHugh K, Bates CM (2010) High incidence of vesicoureteral reflux in mice with Fgfr2 deletion in kidney mesenchyma. J Urol 183:2077–2084
Walker KA, Sims-Lucas S, Di Giovanni VE, Schaefer C, Sunseri WM, Novitskaya T, de Caestecker MP, Chen F, Bates CM (2013) Deletion of fibroblast growth factor receptor 2 from the peri-Wolffian duct stroma leads to ureteric induction abnormalities and vesicoureteral reflux. PloS One 8:e56062
Sims-Lucas S, Argyropoulos C, Kish K, McHugh K, Bertram JF, Quigley R, Bates CM (2009) Three-dimensional imaging reveals ureteric and mesenchymal defects in Fgfr2-mutant kidneys. J Am Soc Nephrol 20:2525–2533
Seyedzadeh A, Kompani F, Esmailie E, Samadzadeh S, Farshchi B (2008) High-grade vesicoureteral reflux in Pfeiffer syndrome. Urol J 5:200–202
Wang H, Li Q, Liu J, Mendelsohn C, Salant DJ, Lu W (2011) Noninvasive assessment of antenatal hydronephrosis in mice reveals a critical role for Robo2 in maintaining anti-reflux mechanism. PloS One 6:e24763
Pedersen A, Skjong C, Shawlot W (2005) Lim 1 is required for nephric duct extension and ureteric bud morphogenesis. Dev Biol 288:571–581
Hu P, Deng FM, Liang FX, Hu CM, Auerbach AB, Shapiro E, Wu XR, Kachar B, Sun TT (2000) Ablation of uroplakin III gene results in small urothelial plaques, urothelial leakage, and vesicoureteral reflux. J Cell Biol 151:961–972
Kong XT, Deng FM, Hu P, Liang FX, Zhou G, Auerbach AB, Genieser N, Nelson PK, Robbins ES, Shapiro E, Kachar B, Sun TT (2004) Roles of uroplakins in plaque formation, umbrella cell enlargement, and urinary tract diseases. J Cell Biol 167:1195–1204
Campbell M (2002) Campbell’s urology. Saunders Harcourt Publishing, Philadelphia
Heptinstall RH (1998) Urinary tract infection, pyelonephritis, reflux nephropathy. In: Jennette JC, Olson JL, Schwartz MM, Silva FG (eds) Heptinstall’s pathology of the kidney, 5th edn. Page 746, Lippincott-Raven, Philadelphia
Mattoo TK (2011) Vesicoureteral reflux and reflux nephropathy. Adv Chron Kidney Dis 18:348–354
Ransley PG, Risdon RA (1978) Reflux and renal scarring. Br J Radiol 14:1–34
Torres VE, Kramer SA, Holley KE, Johnson CM, Hartman GW, Kallenius G, Svenson SB (1985) Interaction of multiple risk factors in the pathogenesis of experimental reflux nephropathy in the pig. J Urol 133:131–135
Bowen SE, Watt CL, Murawski IJ, Gupta IR, Abraham SN (2013) Interplay between vesicoureteric reflux and kidney infection in the development of reflux nephropathy in mice. Dis Model Mech 6:934–941
Ragnarsdottir B, Lutay N, Gronberg-Hernandez J, Koves B, Svanborg C (2011) Genetics of innate immunity and UTI susceptibility. Nat Rev Urol 8:449–468
Acknowledgments
This work was supported by a grant from the Canadian Institute of Health Research to IRG. IRG holds a scholarship award from the Fonds de la Recherche en Santé du Québec.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fillion, ML., Watt, C.L. & Gupta, I.R. Vesicoureteric reflux and reflux nephropathy: from mouse models to childhood disease. Pediatr Nephrol 29, 757–766 (2014). https://doi.org/10.1007/s00467-014-2761-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00467-014-2761-3