Relationship between prematurity, high blood pressure and kidney injury

Abstract

Introduction: Prematurity is a public health problem worldwide. Reducing the morbidity and mortality of prematurity through improved management techniques reveal the emergence of cardiovascular risk diseases, including kidney disease and high blood pressure, which can compromise health in adulthood. The prevalence of these diseases varies from country to country. The main objective of this study was to determine the factors associated with renal injury and high blood pressure in children born preterm. Methodology: We conducted a historical cohort study including children aged 6 to 11 years, matched for gender and sex in a 1:2 ratio. Data were collected from the records of premature and full-term infants hospitalized from January 1, 2008 to December 31, 2013. Patients were reviewed during outpatient consultation, where height, blood pressure were measured and a urine dipstick was performed. Patients with high blood pressure or positive protein uria were seen again two weeks later for follow-up. The Fisher test and the Chi-square test were used to compare proportions. The significance threshold was defined for p<0.05. Relative risk (RR) was used to establish the risk relationship between the different variables. Results: We enrolled 125 children born preterm and 250 born at full-term. The mean age was 8.2+/-1.6 years with discrete female predominance. The cumulative incidence of pathologies varied according to type: 17.60% in preterm versus 2% in full-term (p?0,001) for high blood pressure and 69.60% in preterm versus 33.20% in full-term children (p?0,001) for proteinuria. Factors associated with renal in jury were the use of amino glycosides, aminophylline and neonatal infection. We found a correlation between the presence of proteinuria and high blood pressure (r=1.14, p=0.000002). Conclusion: Renal damage and high blood pressure were more common in children born preterm than in full-term. Associated factors were neonatal infection, use of amino glycosides and aminophylline.

Preterm Birth, Kidney Function and Cardiovascular Disease in Children and Adolescents

“…However, findings from the studies that have examined long-term renal function after preterm birth are less conclusive. The parameters that have been examined in published literature are microalbuminuria as an early sign of hyperfiltration, albuminuria, levels of blood urea nitrogen, serum creatinine, serum cystatin C, estimated GFR (eGFR), impairments in electrolyte excretions and newer biomarkers of renal dysfunction, such as serum or urine neutrophil gelatinase-associated lipocalin (NGAL), symmetric dimethylarginine (SDMA) and serum b2 microglobulin ( Table 1 ) [ 21 , 23 , 24 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 40 , 41 , 42 , 43 , 44 , 45 ]. There are a few studies on school-aged children and adolescents that did not observe any difference in eGFR between ex-preterm and term children [ 24 , 25 , 42 ].…”