Effects of prematurity on long-term renal health: a systematic review

Abstract

ObjectiveTo investigate the literature and determine if prematurity has an impact on long-term adverse kidney outcomes.DesignSystematic review.Data sourcesOVID Medline, PubMed, SCOPUS, CINAHL and EMBASE databases were searched for studies relating to the adverse outcomes of prematurity from 1990 to April 2021.Eligibility criteria for selecting studiesAll articles published between January 1990 and April 2021 that investigated whether premature infants developed long-term adverse renal outcomes were included in this review. Articles must have been human studies and written in English. Case series with less than 20 participants and case studies were excluded.Data extraction and synthesisOne reviewer completed the database searches. Article selection was performed independently and in a non-blinded manner by both reviewers. Initial screening was by title and abstract. Full texts of remaining articles were reviewed. Articles for which inclusion was unclear were re-reviewed by both reviewers, and a unanimous decision was taken as to whether they should be included. The Newcastle–Ottawa Scale was used for quality assessment of the included articles.ResultsThe literature search yielded 31 human studies, which investigated the short-term and long-term kidney outcomes of prematurity. These studies were conducted in 17 different countries. The most common outcomes measured were blood pressure (BP) and glomerular filtration rate. Other common outcomes measured included kidney size and mass, proteinuria, albuminuria, chronic kidney disease (CKD) and physical parameters such as height, weight and body mass index.ConclusionPrematurity is likely linked to increased risk of kidney dysfunction and high BP in childhood and into early adulthood. Premature birth conferred a twofold increased risk of CKD and extremely premature birth conferred a threefold increased risk of CKD. However, further larger multicentre studies are needed to draw definitive conclusions on the long-term kidney outcomes of prematurity.

Birth weight and subclinical cardiovascular and renal damage in a population-based study (the STANISLAS cohort study)

“…Prematurity is also likely linked to increased risk of kidney dysfunction and high BP in childhood and into early adulthood. Premature birth was found to confer a two-fold increased risk of CKD [46,47]. Our current study also analyzed renal function, as several literature reviews have highlighted prematurity and/or LBW as a marker of impaired nephrogenesis and is related to chronic kidney disease (CKD).…”

The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

“…Although increased rates of renal dysfunction or chronic kidney disease in their later life has been shown in premature infants, there are no reports in the literature addressing the coexistence of proteinuria and ROP development [17]. It has been found that prematurity and low birth weight are associated with fewer nephrons and lower glomerular density [18].…”

Kidney outcomes in early adolescence following perinatal asphyxia and hypothermia-treated hypoxic-ischaemic encephalopathy

“…A recent systematic review on the effect of prematurity on long-term kidney health found that prematurity is likely linked to an increased risk for renal dysfunction and elevated/high BP in childhood and into early adulthood. Extremely premature birth conferred a threefold increase in the risk of CKD, whereas premature birth conferred a twofold increase in the risk of CKD [ 38 ].…”