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Long‐term renal follow up of preterm neonates born before 35 weeks of gestation
Author(s) -
Horie Akiyoshi,
Abe Yasuhiro,
Koike Daisuke,
Hirade Tomohiro,
Nariai Akiyoshi,
Ito Tomoko,
Katou Fumihide
Publication year - 2019
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.14004
Subject(s) - medicine , gestation , term (time) , obstetrics , pediatrics , gestational age , pregnancy , genetics , biology , physics , quantum mechanics
Abstract Background The hypothesis of the Developmental Origins of Health and Disease states that environmental factors during fetal and infantile life are risk factors for some chronic diseases in adulthood. Few studies, however, have confirmed this hypothesis early in childhood. Therefore, we assessed how premature birth and low‐birthweight ( LBW ) affect the renal function of Japanese children. Methods This retrospective study surveyed 168 patients who were born before 35 weeks of gestation and were cared for at the present neonatal intensive care unit. Follow‐up duration was >2 years. Serum creatinine ( sC r) and estimated glomerular filtration rate ( eGFR ) recorded in medical records were reviewed. Results The eGFR at 2 years of age was significantly correlated with birthweight and gestational age ( P < 0.01). Approximately 10.7% of the children had low eGFR (<90 mL /min/1.73 m 2 ) without clinical symptoms or abnormal urine examination. These children had high sC r on day 7 after birth ( P < 0.01) and delayed recovery of these levels during the first month after birth. Conclusion Premature gestational age and LBW directly affect renal function in young children. High sC r on day 7 after birth is a risk factor for chronic kidney disease in children. Careful follow up of renal function is therefore required for premature infants and infants with LBW beginning in early childhood to prevent renal dysfunction.