Skip to main content

Advertisement

Log in

Renal function, renal volume, and blood pressure in infants with antecedent of antenatal steroids

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Steroids have been used for more than 20 years in preterm infants to induce pulmonary maturity; however, some long-term effects have been reported, such as insulin resistance and elevation of blood pressure. The aim of our study was to compare renal volume, renal function, and blood pressure in infants between 12–36 months of age with and without antecedent of antenatal steroid treatment. This was a cross-sectional study comprised of three groups of infants (n = 30, respectively): preterm infants with and without antecedent of receiving antenatal steroids, respectively, and full-term infants. Blood pressure, renal volume, glomerular filtration rate, and tubular function were measured. Blood pressure and cystatin C levels and glomerular filtration rate were higher in both groups of preterm infants than in the control group (p < 0.01). However, no difference in any of the tested variables between the steroid and non-steroid group of preterm infants. Renal volume was similar in preterm and control infants. Based on these results, we conclude that prematurity independent of antenatal steroid use is associated with higher cystatin C and blood pressure levels and a higher glomerular filtration rate in infants between 12–36 months of age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Liggins GC, Howie RN (1972) A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 50:515–525

    CAS  PubMed  Google Scholar 

  2. Canterino JC, Verma U, Visintainer PF, Elimian A, Klein SA, Tejani N (2001) Antenatal steroids and neonatal peri ventricular leukomalacia. Obstet Gynecol 97:135–139

    CAS  PubMed  Google Scholar 

  3. Baud O, Foix-L’Helias L, Kaminski M, Audibert F, Jarreau PH, Papiernik E, Huon C, Lepercq J, Dehan M, Lacaze-Masmonteil T (1999) Antenatal glucocorticoid treatment and cystic periventricular leukomalacia in very premature infants. N Engl J Med 341:1190–1196

    Article  CAS  Google Scholar 

  4. Leviton A, Dammann O, Allred EN, Kuban K, Pagano M, Van Marter L, Paneth N, Reuss ML, Susser M (1999) Antenatal corticosteroids and cranial ultrasonographic abnormalities. Am J Obstet Gynecol 181:1007–1017

    Article  CAS  Google Scholar 

  5. Vermillion ST, Soper DE, Chasedunn-Roark J (1999) Neonatal sepsis after betamethasone administration to patients with preterm premature rupture of membranes. Am J Obstet Gynecol 181:320–327

    Article  CAS  Google Scholar 

  6. Vermillion ST, Soper DE, Newman RB (2000) Neonatal sepsis and death after multiple courses of antenatal betamethasone therapy. Am J Obstet Gynecol 183:810–814

    Article  CAS  Google Scholar 

  7. Moss TJ, Sloboda DM, Gurrin LC, Harding R, Challis JR, Newnham JP (2001) Programming effects in sheep of prenatal growth restriction and glucocorticoid exposure. Am J Physiol Regul Integr Comp Physiol 281:R960–R970

    Article  CAS  Google Scholar 

  8. Benediktsson R, Lindsay RS, Noble J, Seckl JR, Edwards CR (1993) Glucocorticoids exposure in utero: new model for adult hypertension. Lancet 341:339–341

    Article  CAS  Google Scholar 

  9. Figueroa JP, Rose JC, Massmann GA, Zhang J, Acuña G (2005) Alterations in fetal kidney development and elevations in arterial blood pressure in young adult sheep after clinical doses of antenatal glucocorticoids. Pediatr Res 58:510–515

    Article  Google Scholar 

  10. Tang L, Bi J, Valego N, Carey L, Figueroa J, Chappell M, Rose JC (2010) Prenatal betamethasone exposure alters renal function in immature sheep: sex differences in effects. Am J Physiol Regul Integr Comp Physiol 299:R793–R803

    Article  CAS  Google Scholar 

  11. Cattarelli D, Chirico G, Simeoni U (2002) Renal effects of antenatally or postnatally administered steroids. Pediatr Med Chir 24:157–162

    CAS  PubMed  Google Scholar 

  12. Celsi G, Kistner A, Aizman R, Eklöf AC, Ceccatelli S, De Santiago A, Jacobson SH (1998) Prenatal dexamethasone causes oligonephronia, sodium retention and higher blood pressure in the offspring. Pediatr Res 44:317–322

    Article  CAS  Google Scholar 

  13. Finken MJ, Keijzer-Veen MG, Dekker FW, Frolich M, Walther FJ, Romijn JA, van der Heijden BJ, Wit JM, Dutch POPS-19 Collaborative Study Group (2008) Antenatal glucocorticoid treatment is not associated with long-term metabolic risks in individuals born before 32 weeks of gestation. Arch Dis Child Fetal Neonatal Ed 93:F442–F447

    Article  CAS  Google Scholar 

  14. Brenner BM, Chertow GM (1993) Congenital oligonephropathy: An inborn cause of adult hypertension and progressive renal injury? Curr Opin Nephrol Hypertens 2:691–695

    Article  CAS  Google Scholar 

  15. Silver LE, Decamps PJ, Korst LM, Platt LD, Castro LC (2003) Intrauterine growth restriction is accompanied by decreased renal volume in the human fetus. Am J Obstet Gynecol 188:1320–1325

    Article  Google Scholar 

  16. Zhang J, Massmann GA, Rose JC, Figueroa JP (2010) Differential effects of clinical doses of antenatal betamethasone on nephron endowment and glomerular filtration rate in adult sheep. Reprod Sci 17:186–195

    Article  CAS  Google Scholar 

  17. Amador-Licona N, Guízar-Mendoza JM, Maciel-Miranda JA, Romero-Gutiérrez G (2007) Antenatal dexamethasone and renal vascular resistance in preterm infants. J Paediatr Child Health 43:303–306

    Article  Google Scholar 

  18. Hricak H, Lieto RP (1983) Sonographic determination of renal volume. Radiology 148:311–312

    Article  CAS  Google Scholar 

  19. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263

    CAS  PubMed  Google Scholar 

  20. Demarini S, Dollberg S, Hoath SB, Ho M, Donovan EF (1999) Effects of antenatal corticosteroids on blood pressure in very low birth weight infants during the first 24 hours of life. J Perinatol 19(6 pt 1):419–425

    Article  CAS  Google Scholar 

  21. Williams S, St George IM, Silva PA (1992) Intrauterine growth retardation and blood pressure at age seven and eighteen. J Clin Epidemiol 45:1257–1263

    Article  CAS  Google Scholar 

  22. Bonamy AK, Bendito A, Martin H, Andolf E, Sedin G, Norman M (2005) Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res 58:845–849

    Article  Google Scholar 

  23. Hofman PL, Regan F, Jefferies CA, Cutfield WS (2006) Prematurity and programming: are there later metabolic sequelae? Metab Syndr Relat Disord 4:101–112

    Article  Google Scholar 

  24. Abdel-Hakeem AK, Henry TQ, Magee TR, Desai M, Ross MG, Mansano RZ, Torday JS, Nast CC (2008) Mechanisms of impaired nephrogenesis with fetal growth restriction: altered renal transcription and growth factor expression. Am J Obstet Gynecol 199(3):252.e1–7

    Article  Google Scholar 

  25. Duong Van Huyen JP, Viltard M, Nehiri T, Freund N, Bélair NF, Martinerie C, Lelongt B, Bruneval P, Lelièvre-Pégorier M (2007) Expression of matrix metalloproteinases MMP-2 and MMP-9 is altered during nephrogenesis in fetuses from diabetic rats. Lab Invest 87:680–689

    Article  CAS  Google Scholar 

  26. Woods LL, Ingelfinger JR, Nyengaard JR, Rasch R (2001) Maternal protein restriction suppresses the newborn renin-angiotensin system and programs adult hypertension in rats. Pediatr Res 49:460–467

    Article  CAS  Google Scholar 

  27. Baserga M, Hale MA, Wang ZM, Yu X, Callaway CW, McKnight RA, Lane RH (2007) Uteroplacental insufficiency alters nephrogenesis and down regulates cyclooxygenase-2 expression in a model of IUGR with adult-onset hypertension. Am J Physiol Regul Integr Comp Physiol 292:R1943–R1955

    Article  CAS  Google Scholar 

  28. Bertram C, Trowern AR, Copin N, Jackson AA, Whorwood CB (2001) The maternal diet during pregnancy programs altered expression of the glucocorticoid receptor and type 2 11beta-hydroxysteroid dehydrogenase: potential molecular mechanisms underlying the programming of hypertension in utero. Endocrinology 142:2841–2853

    Article  CAS  Google Scholar 

  29. Pham TD, MacLennan NK, Chiu CT, Laksana GS, Hsu JL, Lane RH (2003) Uteroplacental insufficiency increases apoptosis and alters p53 gene methylation in the full-term IUGR rat kidney. Am J Physiol Regul Integr Comp Physiol 285:R962–R970

    Article  CAS  Google Scholar 

  30. Ekelund U, Ong KK, Linne Y, Neovius M, Brage S, Dunger DB, Wareham NJ, Rossner S (2007) Association of weight gain in infancy and early childhood with metabolic risk in young adults. J Clin Endocrinol Metab 92:98–103

    Article  CAS  Google Scholar 

  31. Singhal A, Cole TJ, Lucas A (2001) Early nutrition in preterm infants and later blood pressure: two cohorts after randomized trials. Lancet 357:413–419

    Article  CAS  Google Scholar 

  32. Kramer MS, Matush L, Vanilovich I, Platt RW, Bogdanovich N, Sevkovskaya Z, Dzikovich I, Shishko G, Collet JP, Martin RM, Davey Smith G, Gillman MW, Chalmers B, Hodnett E, Shapiro S, PROBIT Study Group (2007) Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 y: evidence from a large randomized trial. Am J Clin Nutr 86:1717–1721

    Article  CAS  Google Scholar 

  33. Salgado JV, Neves FA, Bastos MG, França AK, Brito DJ, Santos EM, Salgado Filho N (2010) Monitoring renal function: measured and estimated glomerular filtration rates—a review. Braz J Med Biol Res 43:528–536

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Juan M. Guízar-Mendoza.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carballo-Magdaleno, D., Guízar-Mendoza, J.M., Amador-Licona, N. et al. Renal function, renal volume, and blood pressure in infants with antecedent of antenatal steroids. Pediatr Nephrol 26, 1851–1856 (2011). https://doi.org/10.1007/s00467-011-1860-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-011-1860-7

Keywords

Navigation