[32] In the postnatal period in the pig, NOS activity is greatest in the pre-glomerular

resistance vasculature of the newborn kidney immediately after birth, but decreases as maturation progresses.[33] Furthermore, the different isoforms of NOS differentially regulate renal vasodilatation during the neonatal period compared with the adult. Expression of the neuronal isoform of NOS (nNOS) in the renal resistance vasculature is greatest in the newborn pig, but expression of endothelial NOS (eNOS) is greatest in the adult.[32] In selleckchem alignment with this, nNOS predominantly contributes to renal blood flow in the postnatal period but Ferrostatin-1 nmr eNOS contributes to renal blood flow in the adult.[32]

Importantly, expression of nNOS has been shown to be greatest in the macula densa of the developing kidney of the pig,[32] a site important in modulating TGF activity. An increase in NO production has been shown to decrease the sensitivity of TGF.[34] Thus, it can be inferred that NO produced by nNOS facilitates the decrease in afferent arteriolar resistance in the postnatal period by decreasing the sensitivity of TGF. Although nNOS appears to be important in the resetting of TGF, it is not necessary in the long term since nNOS knockout mice have a normal TGF response.[29] This is supported by the fact that nNOS expression declines but expression of eNOS increases during the postnatal period.[32] Presumably this increase in eNOS expression compensates for the decline in expression of nNOS and in the long term, eNOS maintains basal renal haemodynamics. Nevertheless, it appears that the high expression

of nNOS at birth[32] is necessary to reset the sensitivity of TGF and promote afferent vascular dilatation. Normal postnatal maturation of the kidney is characterized by however both functional and structural adaptations of the glomerulus and tubules. The following sections of this review will focus firstly on both the structural and functional adaptations to nephron loss. We will then put forward a hypothesis regarding mechanisms via which compensatory renal growth may be implicated in the onset of hypertension and chronic kidney disease. Compensatory renal growth also occurs following surgical reduction in renal mass (uninephrectomy or sub-total nephrectomy) and is associated with significant hypertrophy of the tubules and the glomeruli. In the rat kidney, the increase in length of proximal tubules can be as much as 70–90%[10, 35, 36] with a more modest (17–40%) increase in length occurring in the distal tubules.