Abstract
Impaired renal development during foetal life is a proposed mechanism for adult hypertension in people born small. Whether preterm birth contributes to such adverse development is still unclear. We investigated the selective contributions from foetal growth restriction or preterm birth to renal function and volume in children with low birth weight. Three groups of 9 to 12-year-old children were studied: those born at < 32 gestational weeks (preterm, n = 39), those born at term but small for gestational age (SGA, n = 29) and those born at the term appropriate for gestational age (controls, n = 37). We estimated renal function by calculating glomerular filtration rate (GFR) and by measuring urinary proteins. Volumetric ultrasound of the kidneys was performed in 86 children (preterm, n = 33; SGA, n = 25; controls, n = 29). Estimated glomerular filtration rate (eGFR) and urinary protein patterns were similar between the groups. Kidney volume (preterm 162 ml (31); SGA 163 ml (26) and controls 182 ml (47)) was smaller in the preterm group than in the controls, but the difference was not significant when adjusted for body surface area, gender and age (P = 0.25). Total renal volume correlated to birth weight (r = 0.23, P = 0.03). No significant differences were found in renal function or volume between the three groups at school age.
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Barker DJ, Osmond C, Golding J, Kuth PD, Wadsworth MEJ (1989) Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ 298:564–567
Brenner BM, Garcia DL, Anderson S (1988) Glomeruli and blood pressure: Less of one, more the other? Am J Hypertens 1:335–347
Brenner BM, Chertow GM (1994) Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis 23:171–175
Hinchlife SA, Lynch MR, Sargent PH, Howard CV, Van Velzen D (1992) The effect of intrauterine growth retardation on the development of renal nephrons. Br J Obstet Gynaecol 99:296–301
Manalich R, Reyes L, Herrera M, Melendi C, Fundora I (2000) Relationship between weight at birth and the number and size of renal glomeruli in humans: a histomorphometric study. Kidney Int 58:770–773
Merlet-Benichou C, Gilbert T, Muffat-Joly M, Lelievre-Pegorier M, Leroy B (1994) Intrauterine growth retardation leads to a permanent nephron deficit in the rat. Pediatr Nephrol 8:175–180
Hughson MD, Douglas-Denton R, Bertram JF, How WE (2006) Hypertension, glomerular number, and birth weight in African Americans and white subjects in the southeastern United States. Kidney Int 69:671–678
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
Fan ZJ, Lackland DT, Lipsitz SR, Nicholas JS (2006) The association of low birth weight and chronic renal failure among Medicaid young adults with diabetes and/or hypertension. Public Health Rep 121:239–244
Hoy WE, Rees M, Kile E, Mathews JD, McCredie DA, Pugsley DJ, Wang Z (1998) Low birth weight and renal disease in Australian aborigines. Lancet 352:1826–1827
Vanpée M, Blennow M, Linné T, Herin P, Apeira A (1992) Renal function in very low birth weight infants: normal maturity reached during early childhood. J Pediatr 121:784–788
Johansson S, Norman M, Legnevall L, Dalmaz Y, Lagercrantz H, Vanpée M (2007) Increased catecholamines and heart rate in children with low birth weight: perinatal contributions to sympathoadrenal overactivity. J Intern Med 261:480–487
Edstedt 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
Kistner A, Celsi G, Vanpée M, Jacobson SH (2000) Renal function and blood pressure control in adult women born preterm or small for gestational age. Pediatr Nephrol 15:215–220
Johansson S, Iliadou A, Bergvall N, Tuvemo T, Norman M, Cnattingius S (2005) Risk of high blood pressure among young men increases with the degree of immaturity at birth. Circulation 112:3430–3436
Høgberg U (1997) Early dating by ultrasound and perinatal outcome. A cohort study. Acta Obstet Gynecol Scand 76:907–912
Marsal K, Persson PH, Larsen T, Lilja H, Selbing A, Sultan B (1996) Intrauterine growth curves based on ultrasonically estimated foetal weights. Acta Paediatr 85:843–848
Morris SS, Victoria CG, Barros FC, Halpern R, Menezes, AMB, César JA, Horta BL, Tomasi E (1998) Length and ponderal index at birth: associations with mortality, hospitalizations, development and post-natal growth in Brazilian infants. Int J Epidemiol 27:242–247
Roberts JM, Pearson G, Cutler J, Lindheimer M (2003) Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension 41:437–445
Schwartz GJ, Haycock GB, Edelman 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
Park MK, Menard SM (1987) Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 79:907–914
Dinkel E, Ertel M, Dittrich M, Peters H, Berres M, Schulte Wissermann H (1985) Kidney size in childhood. Sonographical growth charts for kidney length and volume. Pediatr Radiol 15:38–43
Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height weight formula validated in infants, children and adults. J Pediatr 93:62–66
Lane PH, Belsha CW, Plummer J, Steinhardt GF, Lynch RE, Wood EG (1998) Relationship of renal size, body size, and blood pressure in children. Pediatr Nephrol 12:35–39
Srivastava T (2006) Nondiabetic consequences of obesity on kidney. Pediatr Nephrol 21:463–470
Saran AM, Hsu FC, Lohman KK, Carr JJ, Bowden DW, Wagenknecht LE, Freedman BI (2008) Kidney volume associations with subclinical renal and cardiovascular disease: the diabetes heart study. Am J Nephrol 28:366–371
Schmidt IM, Chellakooty M, Boisen KA, Damgaard IN, Mau KC, Olgaard K, Main KM (2005) Impaired kidney growth in low-birth-weight children: distinct effects of maturity and weight for gestational age. Kidney Int 68:731–740
Keijzer-Veen MG, Schrevel M, Finken MJ, Dekker FW, Nauta J, Hille ET, Frolich M, van der Heijden BJ (2005) Dutch POPS-19 Collaborative Study Group. Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 9:2762–2768
Rodríguez-Soriano J, Aguirre M, Oliveros R, Vallo A (2005) Long-term renal follow-up of extremely low birth weight infants. Pediatr Nephrol 20:579–584
Nyengaard JR, Bendtsen TF (1992) Glomerular number and size in relation to age, kidney weight and body surface in normal man. Anat Rec 232:194–201
Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25
Rodríguez MM, Gómez A, Abitbol C, Chandar J, Montané B, Zilleruelo G (2005) Comparative renal histomorphometry: a case study of oligonephropathy of prematurity. Pediatr Nephrol 20:945–949
Cuzzolin L, Fanos V, Pinna B, di Marzio M, Perin M, Tramontozzi P, Tonetto P, Cataldi L (2006) Postnatal renal function in the preterm newborns: a role of diseases, drugs and therapeutic interventions. Pediatr Nephrol 21:931–938
Acknowledgements
The study was funded by the May Flower Annual Campaign for Children’s Health, the Swedish Medical Association, Sällskapet Barnavård, Mjölkdroppen Foundation, Freemason Children’s Foundation in Stockholm, and the Swedish Heart and Lung Foundation. We sincerely thank the participating children and their families for making this study possible.
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Rakow, A., Johansson, S., Legnevall, L. et al. Renal volume and function in school-age children born preterm or small for gestational age. Pediatr Nephrol 23, 1309–1315 (2008). https://doi.org/10.1007/s00467-008-0824-z
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DOI: https://doi.org/10.1007/s00467-008-0824-z