Hypoxia-induced intrauterine growth restriction increases the risk for chronic diseases in adults, affecting more than 140 million high altitude residents worldwide. Still, not much is known about the fetal mechanisms that prone these individuals to disease. Using bottom-up proteomics and the kidney as a readout, we delineated a dichotomous response to chronic hypoxic stress, comprising mechanisms that promote survival, but also induce premature senescence. Combined outcome is the manifestation of a predetermined aging phenotype already during fetal development. This aging phenotype is associated with a characteristic biomarker profile in tissue and blood serum samples, exploitable for targeting and monitoring disease.