OBJECTIVE Differentiation of the metanephros is abnormal in cases of renal dysplasia, resulting in abnormal kidney organization. In vitro and in vivo studies indicate that glial cell line derived neurotrophic factor (GDNF) is a major regulator of kidney development and ureteral arborization. Therefore, we investigated the pattern of GDNF gene expression in human dysplastic kidneys. METHODS Specimens of whole tissues of human normal and dysplastic kidneys associated with obstructive uropathy were analyzed for GDNF mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR). Immunohistochemistry with GDNF antibody and laser capture microdissection plus RT-PCR were done to identify cells producing GDNF. Apoptosis, BCL-2 and Ki67 were also studied. RESULTS There were few if any GDNF transcripts in normal kidneys, whereas GDNF was over expressed in renal dysplasia specimens. Strong GDNF expression was found in the dysplastic tubules of dysplastic kidneys, whereas peritubular mesenchyma expressed no GDNF protein. Laser capture microdissection/RT-PCR detected GDNF mRNA in epithelial cells isolated from dysplastic tubules but not in cells from the surrounding mesenchyma, which was confirmed by sequence analysis. GDNF expression by epithelial cells was associated with high proliferation, BCL-2 expression and rare apoptosis. CONCLUSIONS GDNF gene expression is restricted to the tubular epithelium of dysplastic human kidneys. Our results strongly suggest that GDNF not only influences kidney morphogenesis, but is also implicated in abnormal kidney development.