Kidneys in 5-year-old preterm-born children: a longitudinal cohort monitoring of renal function

Abstract

BackgroundBeing aware of the impact of low birth weight on late-onset hypertension, our aim was to describe systolic blood pressure (sBP) and renal function in 3-5-year-old preterm-born children and to determine which perinatal factors or childhood factors were associated with an altered renal function at 5 years in these children.MethodsThis was a prospective longitudinal cohort study of children born at 27-31 weeks of gestation and included at birth and examined at 3, 4, and 5 years of age. The primary outcome was renal function at 5 years: BP, estimated glomerular filtration rate, and albuminuria.ResultsOne hundred and sixty five children were examined, of whom 93 (56.4%) were male. Gestational age was 29.2±1.4 weeks and birth weight was 1,217±331 g. Overall, 25% children had sBP ≥90th percentile at age 3 and 4 years and 11% at 5 years. In multivariate analysis, sBP ≥90th percentile at 5 years was associated with the use of antenatal steroids (OR=0.19(0.05;0.65)). There was a significant association between protein intake on day 28 and sBP at 5 years (β=2.1±1.0, P=0.03). Glomerular filtration rate at 5 years was significantly decreased in case of hyaline membrane disease or necrotizing enterocolitis. High urine albumin was not predictable from one year to another.ConclusionIn preterm-born children, sBP was often high and neonatal protein intake was associated with increased blood pressure during childhood.

Current Obesity Was Associated with Hypertension in Children Born Very Low Birth Weight

“…The overall prevalence of hypertension in this cohort was higher than that of the previous reports of hypertension in children born preterm and VLBW, ranging from 6-13% 5,6,22 . This discordant nding could be explained by the fact that the present study used ABPM that can detect masked hypertension, while the previous studies used only the o ce blood pressure measurements.…”

“…The other studies also reported maternal preeclampsia and antenatal steroid as the additional risk factors for hypertension. 5,6 However, this study showed no association between these factors and hypertension. This might be the result of a small number of participants in the present study.…”

“…In preterm survivors, there is a high rate of long-term complications such as recurrent hospitalizations, long-term neurodevelopmental impairment, and chronic health problems, including hypertension and vascular change. Previous studies have shown that preterm with low birth weight is a risk factor for higher o ce blood pressure compared with that of the term and normal birth weight controls [3][4][5][6] .…”

Simplified pulse wave velocity measurement in children: Is the pOpmètre valid?

“…These PWV values were considered abnormal without defined reference values; we therefore think that validating the pOpmètre1 in large cohorts of very young children could allow routine PWV measurement. Indeed, during consultation with the specialist pediatrician, a longterm screening and follow-up could be realized in perinatology networks, pediatric nephrology, and pediatric cardiology for an optimal cardiovascular prevention in children [35][36][37][38][39].…”

Current obesity was associated with hypertension in children born very low birth weight

“…In preterm survivors, there is a high rate of longterm complications such as recurrent hospitalizations, long-term neurodevelopmental impairment, and chronic health problems, including hypertension and vascular change. Previous studies have shown that preterm with low birth weight is a risk factor for higher office blood pressure compared with that of the term and normal birth weight controls [3][4][5][6].…”