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Renal function and systolic blood pressure in very-low-birth-weight infants 1–3 years of age

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Abstract

Background

Preterm very-low-birth-weight (PT-VLBW) infants are at risk of an elevated systolic blood pressure (SBP) in infancy and adulthood; however, the pathogenesis remains unclear. Altered renal development or function may be associated with increased SBP, but their contribution in PT-VLBW is unknown.

Methods

We determined renal function and its relationship to SBP in three groups of PT-VLBW at 1, 2, and 3 years of age, using serum cystatin-C to calculate the estimated glomerular filtration rate (eGFR).

Results

Cystatin-C levels decreased from 0.84 ± 0.2 (SD) within the 1-year group to 0.70 ± 0.1 mg/l (±SD; P < 0.001) at 3 years and were unrelated to gender, fetal growth, and neonatal indomethacin exposure. eGFR rose from 121 ± 59 in the 1-year group to 138 ± 21 ml/min·1.73 m2 (P < 0.001) at 3 years. At 1 year, cystatin-C levels decreased with increasing SBP (P < 0.007), and infants with SBP ≥ 90th% had lower cystatin-C and higher eGFR (P < 0.05). At 3 years, infants with lower birth weight (P < 0.03) and gestational age (P = 0.06) had reduced eGFR.

Conclusions

Preterm very-low-birth-weight infants demonstrate increasing renal function with advancing age. An elevated SBP and eGFR at 1 year suggests dysfunctional renal autoregulation and hyperfiltration, which may alter subsequent renal function and contribute to the lower eGFR seen at 3 years in infants with the lowest birth weight and gestational age.

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Acknowledgements

This study was supported by a Marshall Klaus Research Award from the American Academy of Pediatrics, Section on Perinatal Pediatrics awarded to Dr Duncan and the George M MacGregor Professorship in Pediatrics awarded to Dr Rosenfeld.

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical School at Dallas, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9002, USA

    Joshua A. Frankfurt, Andrea F. Duncan, Roy J. Heyne & Charles R. Rosenfeld

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  1. Joshua A. Frankfurt
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  2. Andrea F. Duncan
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  3. Roy J. Heyne
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  4. Charles R. Rosenfeld
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Correspondence to Charles R. Rosenfeld.

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Frankfurt, J.A., Duncan, A.F., Heyne, R.J. et al. Renal function and systolic blood pressure in very-low-birth-weight infants 1–3 years of age. Pediatr Nephrol 27, 2285–2291 (2012). https://doi.org/10.1007/s00467-012-2265-y

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  • DOI: https://doi.org/10.1007/s00467-012-2265-y

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