Secondary Focal Segmental Glomerulosclerosis in an Adolescent Born with a Very Low Birth Weight

Fuke, Yoshinobu; Murata, Yusuke; Hemmi, Seiichiro; Kajiwara, Mamiko; Yabuki, Minako; Fujita, Takayuki; Soma, Masayoshi

doi:10.2169/internalmedicine.53.2552

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…The authors suspected that obesity or primary glomerulonephritis might have acted as a second hit. Since then, several reports have shown that obesity can accelerate the post-adaptive FSGS in individuals born with LBW (17,18); however, whether or not pregnancy can act as a second hit is unknown.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Is a Risk Factor for Secondary Focal Segmental Glomerulosclerosis in Women with a History of Very Low Birth Weight

et al. 2017

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Low birth weight (LBW) has been known to increase the susceptibility to renal injury in adulthood. A 26-year-old woman developed proteinuria in early pregnancy; she had been born with very LBW. The clinical course was progressive, and an emergency Caesarean section was performed at 36 weeks due to acute kidney injury. A renal biopsy provided a diagnosis of post-adaptive focal segmental glomerulosclerosis. Increased demand for glomerular filtration during early pregnancy appeared to have initiated the renal injury. This report highlights the fact that pregnancy might be a risk factor for renal injury in women born with LBW.

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Section: Discussionmentioning

confidence: 99%

Pregnancy Is a Risk Factor for Secondary Focal Segmental Glomerulosclerosis in Women with a History of Very Low Birth Weight

et al. 2017

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“…The authors also concluded that glomerular density was positively correlated with birthweight and the duration of fetal life, supporting the theory that hyperfiltration has occurred in the histological changes of DOHaD‐related CKD. Similarly, several Japanese reports of FSGS in Japanese children born with prematurity can be explained by the DOHaD theory 64–66 . Thus, it is assumed that glomerular volume increases as the number of nephrons decrease and compensates to maintain the total glomerular volume.…”

Section: Progression Process Of Renal Impairment Based On the Dohad T...mentioning

confidence: 95%

“…Similarly, several Japanese reports of FSGS in Japanese children born with prematurity can be explained by the DOHaD theory. [64][65][66] Thus, it is assumed that glomerular volume increases as the number of nephrons decrease and compensates to maintain the total glomerular volume. However, this compensatory mechanism has its limits, and eventually, eGFR will decrease as the number of glomeruli decreases, regardless of the compensation for volume.…”

Section: Hyperfiltration Theorymentioning

confidence: 99%

The developmental origins of health and chronic kidney disease: Current status and practices in Japan

Nishizaki

Shimizu

2022

Pediatrics International

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The concept of the developmental origins of health and disease (DOHaD) views unfavorable perinatal circumstances as contributing to the development of diseases in later life. It is well known that such unfavorable circumstances play an important role as a risk factor for chronic kidney disease (CKD) in infants born with prematurity. Low birthweight (LBW) is believed to be a potential contributor to CKD in adulthood. Preterm and/or LBW infants are born with incomplete nephrogenesis. As a result, the number of nephrons is low. The poor intrauterine environment also causes epigenetic changes that adversely affect postnatal renal function. After birth, hyperfiltration of individual nephrons due to low nephron numbers causes proteinuria and secondary glomerulosclerosis. Furthermore, the risk of CKD increases as renal damage takes a second hit from exposure to nephrotoxic substances and acquired insults such as acute kidney injury after birth among infants in neonatal intensive care. Meanwhile, unfortunately, recent studies have shown that the number of nephrons in healthy Japanese individuals is approximately two-thirds lower than that in previous reports. This means that Japanese premature infants are clearly at a high risk of developing CKD in later life. Recently, several DOHaD-related CKD studies from Japanese researchers have been reported. Here, we summarize the relevance of CKD in conjunction with DOHaD and review recent studies that have examined the impact of the upward LBW trend in Japan on renal health.

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“…Forty-five years have passed since the screening of renal diseases by school urinalysis started in Japan. Recently, some reports showed that glomerulosclerosis (FSGS) patients born with FGR were diagnosed as a result of regular screening tests at their school 39,40,41) . It is also known that tubular dysfunction commonly occurs in ELBW survivors 42) .…”

Section: Monitoring For the Future Development Of Ckd And Hypertensionmentioning

confidence: 99%

Low Birth Weight Associated with a High Risk of Lifestyle-related Diseases: Fetal Programing During the Developmental Stage

Suzuki

Nakano

Murano

et al. 2021

Juntendo Medical Journal

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Lifestyle-related diseases have been considered to be caused by genetic factors and lifestyle. In recent years, it has been reported that there is a third factor, based on the developmental origin of health and disease (DOHaD), which involves environmental factors during fetal life and development that are related to health in adulthood and the risk of developing lifestyle-related diseases. In Japan, the percentage of low birth weight (LBW) infants born below 2,500 g has been increasing since around 1980, which seems to correlate with the increase in thinness (body mass index <18.5 kg/m 2 ) of women in their 20s and 30s, inadequate caloric intake during pregnancy, and increasing age at first birth. It is interpreted that infants who acquire a thrifty constitution through this process become relatively overnourished as the nutritional environment improves after birth, leading to an increased risk of developing lifestyle-related diseases. Since it is difficult to correct the acquired frugality after birth, pediatricians need to be aware of the future development of obesity and insulin resistance when monitoring adolescents and young adults born as LBW infants. Physicians caring for adults also need to pay attention to the patient's birth history, when the patient has a lifestyle-related disease.

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Secondary Focal Segmental Glomerulosclerosis in an Adolescent Born with a Very Low Birth Weight

Cited by 5 publications

References 29 publications

Pregnancy Is a Risk Factor for Secondary Focal Segmental Glomerulosclerosis in Women with a History of Very Low Birth Weight

Pregnancy Is a Risk Factor for Secondary Focal Segmental Glomerulosclerosis in Women with a History of Very Low Birth Weight

The developmental origins of health and chronic kidney disease: Current status and practices in Japan

Low Birth Weight Associated with a High Risk of Lifestyle-related Diseases: Fetal Programing During the Developmental Stage

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