Embryology of the Kidney

Introduction
The development of the urinary tract begins with the formation of the nephrogenic cord in week
four, along which the pronephros, mesonephros and metanephros form. Although the
metanephric kidneys act as functional excretory units as early as week eleven, nephrogenesis is
not complete until week thirty-two when multiple branching events have formed one to three
million collecting tubules. Complex orchestrated interactions between various embryonic tissues,
the mesonephric duct, ureteric bud, and metanephric blastema ensure the correct development of
the urinary tract. Disruptions to these intricate signaling pathways, either genetic or
environmental, result in congenital abnormalities of the kidney and urinary tract (CAKUT)
including renal agenesis and dysplasia, multicystic dysplastic kidney disease and polycystic
kidney disease.
Kidney Development
Embryonic folding during the fourth week of development marks the beginning of the urinary
tract with the formation of a longitudinal mass known as the urogenital ridge. The ridge can
divide into parts depending on the system it forms; the nephrogenic cord will form the urinary
tract while the gonadal ridge will develop into the reproductive system. Beginning rostrally and
progressing caudally, three kidneys will form over a few weeks within the nephrogenic cord:
pronephros, mesonephros, and metanephros.
Three systems of kidneys develop:

 Pronephros
o non-functional
o develop in the cervical region of the nephrogenic cord
o Formed of tubules & a duct
o appears by week 4
o Analogous to kidney of fish
o degenerates by week 5
 Mesonephros
o development induced by pronephric duct
o forms mesonephric duct (Wolffian duct)
o Appears in thoracic & abdominal regions
o Analogous to kidney of amphibians
o interim kidney for 1st trimester
o Function temporarily
o opens into urogenital system and gives rise to male genital system
 Metanephros
o develops from mesonephric outgrowth called ureteric bud during week 5
o fully canalized and functioning at week 10
o Appears pelvis
o nephrogenesis continues through 32 - 36 weeks of gestation
o derivatives include
 Metanephros (Permanent Kidney)
Formed of 2 origins:
1) Ureteric bud (derived from mesonephric duct): gives collecting part of kidney
 ureter
 pelvises
 calyces and collecting ducts
Ureteric bud elongates & penetrates metanephric mass
Stalk of ureteric bud forms ureter & cranial end forms renal pelvis.
Branching of renal pelvis gives 3 major calyces. Branching of major calyces gives minor calyces.
Continuous branching gives straight then arched collecting tubules

2) Metanephric blastema (mass): gives excretory part of kidney

The metanephric cap forms the metanephric vesicle ,which is elongates to form an S-shaped
metanephric tubule.
-The tubule lengthens to form: proximal & distal convoluted tubules + loop of Henle
-The end of each tubule forms glomerular (Bowman’s) capsule,Which is then invaginated by capillaries
(glomerulus).
By week 9
A. Change in position: The kidney ascends from pelvis to abdomen & attains its adult position, caudal to
suprarenal gland.
B. Change in blood supply: As the kidney ascends, its blood supply changes from renal branches of
common iliac arteries into renal branches of abdominal aorta.
C. Rotation: Initially, hilum (site of entry & exit of vessels & nerves) is ventral then rotates medially about
90° & becomes medial.
● Glomerular filtration begins ● Kidney is subdivided into lobes that are visible externally
In full term (end of fetal period)
Lobulation diminishes at the end of fetal period.
● Nephron formation is complete
After birth
Increase in size: due to elongation of tubules and increase in connective tissue between tubules (not due
to increase in number of nephrons)
● Disappearance of kidney lobulation (usually disappear by the end of the first postnatal year)

 aberrant development may result in congenital malformations of the lower urinary tract
 metanephric mesenchyme

 interaction with ureteric bud causes metranephric mesenchyme to differentiate the renal
structures from collecting tubules to glomerulus
 abnormal interaction with ureteric bud may cause malformations
 Ureteropelvic junction with kidney
o canalizes last
o most common site of obstruction in fetuswhich results inhydronephrosis

 Adult kidney
o embryo grows faster caudally causing a change in location of the kidney from S1 - S2 to a
final position of T12 - L3