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Published in: Pediatric Nephrology 9/2013

Open Access 01-09-2013 | Original Article

Extra-uterine renal growth in preterm infants: Oligonephropathy and prematurity

Authors: Yogavijayan Kandasamy, Roger Smith, Ian M. R. Wright, Eugenie R. Lumbers

Published in: Pediatric Nephrology | Issue 9/2013

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Abstract

Background

Nephron number in humans is determined during fetal life. The objective of this study was to investigate the effects of preterm birth on nephron number using renal volume as a surrogate for nephron number.

Methods

This observational study was conducted over 12 months in a tertiary perinatal center. Preterm babies less than 32 weeks of gestation were recruited and followed until discharge. Term infants were recruited for comparison. The babies underwent renal sonography and renal function measurements at 32 and 38 weeks corrected age. The primary outcome measurement was total kidney volume at 38 weeks and the secondary outcome was estimated glomerular filtration rate (eGFR).

Results

Forty-four preterm infants and 24 term infants were recruited. At 38 weeks corrected age, premature infants had lower total kidney volume than term infants (21.6 ± 5.7 vs. 25.2 ± 5.7 ml; p = 0.02) and a significantly lower eGFR (73.6 [IQR 68.1–77.6] vs. 79.3 [IQR 72.5–86.6] ml·min−1·1.73 m−2; p = 0.03). There was a significant correlation between total kidney volume and eGFR in premature and term babies.

Conclusions

Premature infants have smaller kidney volume and likely decreased nephron number and lower estimated glomerulofiltration rate relative to infants born at term.
Literature
1.
go back to reference Bacchetta J, Harambat J, Dubourg L, Guy B, Liutkus A, Canterino I, Kassai B, Putet G, Cochat P (2009) Both extrauterine and intrauterine growth restriction impair renal function in children born very preterm. Kidney Int 76:445–452PubMedCrossRef Bacchetta J, Harambat J, Dubourg L, Guy B, Liutkus A, Canterino I, Kassai B, Putet G, Cochat P (2009) Both extrauterine and intrauterine growth restriction impair renal function in children born very preterm. Kidney Int 76:445–452PubMedCrossRef
4.
go back to reference Wang H, Gao X, Liu C, Yan C, Lin X, Yang C, Lin Z, Zhu W, Yang Z, Yu F, Qiu Y, Liu X, Zhou X, Chen C, Sun B (2012) Morbidity and mortality of neonatal respiratory failure in China: surfactant treatment in very immature infants. Pediatrics 129:e731–e740PubMedCrossRef Wang H, Gao X, Liu C, Yan C, Lin X, Yang C, Lin Z, Zhu W, Yang Z, Yu F, Qiu Y, Liu X, Zhou X, Chen C, Sun B (2012) Morbidity and mortality of neonatal respiratory failure in China: surfactant treatment in very immature infants. Pediatrics 129:e731–e740PubMedCrossRef
5.
go back to reference Miljeteig I, Sayeed SA, Jesani A, Johansson KA, Norheim OF (2009) Impact of ethics and economics on end-of-life decisions in an Indian neonatal unit. Pediatrics 124:e322–e328PubMedCrossRef Miljeteig I, Sayeed SA, Jesani A, Johansson KA, Norheim OF (2009) Impact of ethics and economics on end-of-life decisions in an Indian neonatal unit. Pediatrics 124:e322–e328PubMedCrossRef
6.
go back to reference Sutherland MR, Gubhaju L, Black MJ (2011) Stereological assessment of renal development in a baboon model of preterm birth. Am J Nephrol 33:25–33PubMedCrossRef Sutherland MR, Gubhaju L, Black MJ (2011) Stereological assessment of renal development in a baboon model of preterm birth. Am J Nephrol 33:25–33PubMedCrossRef
7.
go back to reference Stelloh C, Allen KP, Mattson DL, Lerch-Gaggl A, Reddy S, El-Meanawy A (2012) Prematurity in mice leads to reduction in nephron number, hypertension, and proteinuria. Transl Res 159:80–89PubMedCrossRef Stelloh C, Allen KP, Mattson DL, Lerch-Gaggl A, Reddy S, El-Meanawy A (2012) Prematurity in mice leads to reduction in nephron number, hypertension, and proteinuria. Transl Res 159:80–89PubMedCrossRef
8.
go back to reference Sutherland MR, Gubhaju L, Moore L, Kent AL, Dahlstrom JE, Horne RSC, Hoy WE, Bertram JF, Black MJ (2011) Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol 22:1365–1374PubMedCrossRef Sutherland MR, Gubhaju L, Moore L, Kent AL, Dahlstrom JE, Horne RSC, Hoy WE, Bertram JF, Black MJ (2011) Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol 22:1365–1374PubMedCrossRef
9.
go back to reference Rodriguez MM, Gomez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25PubMedCrossRef Rodriguez MM, Gomez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25PubMedCrossRef
10.
go back to reference Hodgin JB, Rasoulpour M, Markowitz GS, D’Agati VD (2009) Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 4:71–76PubMedCrossRef Hodgin JB, Rasoulpour M, Markowitz GS, D’Agati VD (2009) Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 4:71–76PubMedCrossRef
11.
go back to reference Bacchetta J, Harambat J, Guy B, Putet G, Cochat P, Dubourg L (2009) Long-term renal outcome of children born preterm: a regular follow-up is needed. Arch Pediatri 16(Suppl 1): S42–S48 Bacchetta J, Harambat J, Guy B, Putet G, Cochat P, Dubourg L (2009) Long-term renal outcome of children born preterm: a regular follow-up is needed. Arch Pediatri 16(Suppl 1): S42–S48
12.
go back to reference Hinchliffe SA, Sargent PH, Howard CV, Chan YF, van Velzen D (1991) Human intrauterine renal growth expressed in absolute number of glomeruli assessed by the disector method and Cavalieri principle. Lab Investig 64:777–784PubMed Hinchliffe SA, Sargent PH, Howard CV, Chan YF, van Velzen D (1991) Human intrauterine renal growth expressed in absolute number of glomeruli assessed by the disector method and Cavalieri principle. Lab Investig 64:777–784PubMed
13.
go back to reference Kandasamy Y, Smith R, Wright IM (2012) Oligonephropathy of prematurity. Am J Perinatol 29:115–120PubMedCrossRef Kandasamy Y, Smith R, Wright IM (2012) Oligonephropathy of prematurity. Am J Perinatol 29:115–120PubMedCrossRef
14.
go back to reference Chaves FJ, Pascual JM, Rovira E, Armengod ME, Redon J (2001) Angiotensin II AT1 receptor gene polymorphism and microalbuminuria in essential hypertension. Am J Hypertens 14:364–370PubMedCrossRef Chaves FJ, Pascual JM, Rovira E, Armengod ME, Redon J (2001) Angiotensin II AT1 receptor gene polymorphism and microalbuminuria in essential hypertension. Am J Hypertens 14:364–370PubMedCrossRef
15.
go back to reference Shah MM, Sampogna RV, Sakurai H, Bush KT, Nigam SK (2004) Branching morphogenesis and kidney disease. Development 131:1449–1462PubMedCrossRef Shah MM, Sampogna RV, Sakurai H, Bush KT, Nigam SK (2004) Branching morphogenesis and kidney disease. Development 131:1449–1462PubMedCrossRef
16.
go back to reference Brenner BM, Garcia DL, Anderson S (1988) Glomeruli and blood pressure. Less of one, more the other? Am J Hypertens 1:335–347PubMedCrossRef Brenner BM, Garcia DL, Anderson S (1988) Glomeruli and blood pressure. Less of one, more the other? Am J Hypertens 1:335–347PubMedCrossRef
17.
go back to reference Brenner BM, Lawler EV, Mackenzie HS (1996) The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 49:1774–1777PubMedCrossRef Brenner BM, Lawler EV, Mackenzie HS (1996) The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 49:1774–1777PubMedCrossRef
18.
go back to reference McFarlane PA (2006) Review: ACE inhibitors delay microalbuminuria in diabetes without nephropathy and reduce mortality in diabetic nephropathy. Evid Based Med 11:144PubMedCrossRef McFarlane PA (2006) Review: ACE inhibitors delay microalbuminuria in diabetes without nephropathy and reduce mortality in diabetic nephropathy. Evid Based Med 11:144PubMedCrossRef
19.
go back to reference Askenazi DJ, Ambalavanan N, Goldstein SL (2009) Acute kidney injury in critically ill newborns: what do we know? What do we need to learn? Pediatr Nephrol 24:265–274PubMedCrossRef Askenazi DJ, Ambalavanan N, Goldstein SL (2009) Acute kidney injury in critically ill newborns: what do we know? What do we need to learn? Pediatr Nephrol 24:265–274PubMedCrossRef
20.
21.
go back to reference Seo BJ, Mun MR, J RK, Kim CJ, Lee I, Chang YH, Park YH (2010) Bile tolerant Lactobacillus reuteri isolated from pig feces inhibits enteric bacterial pathogens and porcine rotavirus. Vet Res Commun 34:323–333PubMedCrossRef Seo BJ, Mun MR, J RK, Kim CJ, Lee I, Chang YH, Park YH (2010) Bile tolerant Lactobacillus reuteri isolated from pig feces inhibits enteric bacterial pathogens and porcine rotavirus. Vet Res Commun 34:323–333PubMedCrossRef
22.
go back to reference van den Anker JN, de Groot R, Broerse HM, Sauer PJ, van der Heijden BJ, Hop WC, Lindemans J (1995) Assessment of glomerular filtration rate in preterm infants by serum creatinine: comparison with inulin clearance. Pediatrics 96:1156–1158PubMed van den Anker JN, de Groot R, Broerse HM, Sauer PJ, van der Heijden BJ, Hop WC, Lindemans J (1995) Assessment of glomerular filtration rate in preterm infants by serum creatinine: comparison with inulin clearance. Pediatrics 96:1156–1158PubMed
23.
go back to reference Greenbaum LA, Munoz A, Schneider MF, Kaskel FJ, Askenazi DJ, Jenkins R, Hotchkiss H, Moxey-Mims M, Furth SL, Warady BA (2011) The association between abnormal birth history and growth in children with CKD. Clin J Am Soc Nephrol 6:14–21PubMedCrossRef Greenbaum LA, Munoz A, Schneider MF, Kaskel FJ, Askenazi DJ, Jenkins R, Hotchkiss H, Moxey-Mims M, Furth SL, Warady BA (2011) The association between abnormal birth history and growth in children with CKD. Clin J Am Soc Nephrol 6:14–21PubMedCrossRef
24.
go back to reference Hricak H, Lieto RP (1983) Sonographic determination of renal volume. Radiology 148:311–312PubMed Hricak H, Lieto RP (1983) Sonographic determination of renal volume. Radiology 148:311–312PubMed
25.
go back to reference Zappitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, Bell L (2006) Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis 48:221–230PubMedCrossRef Zappitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, Bell L (2006) Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis 48:221–230PubMedCrossRef
26.
go back to reference Holloway H, Jones TB, Robinson AE, Harpen MD, Wiseman HJ (1983) Sonographic determination of renal volumes in normal neonates. Pediatr Radiol 13:212–214PubMedCrossRef Holloway H, Jones TB, Robinson AE, Harpen MD, Wiseman HJ (1983) Sonographic determination of renal volumes in normal neonates. Pediatr Radiol 13:212–214PubMedCrossRef
27.
go back to reference Keijzer-Veen MG, Devos AS, Meradji M, Dekker FW, Nauta J, van der Heijden BJ (2010) Reduced renal length and volume 20 years after very preterm birth. Pediatr Nephrol 25:499–507PubMedCrossRef Keijzer-Veen MG, Devos AS, Meradji M, Dekker FW, Nauta J, van der Heijden BJ (2010) Reduced renal length and volume 20 years after very preterm birth. Pediatr Nephrol 25:499–507PubMedCrossRef
28.
go back to reference D’Agostino RB, Belanger A, D’Agostino RB Jr (1990) A suggestion for using powerful and informative tests of normality. Am Stat 44:316–321 D’Agostino RB, Belanger A, D’Agostino RB Jr (1990) A suggestion for using powerful and informative tests of normality. Am Stat 44:316–321
29.
go back to reference Huang H-P, Tsai IJ, Lai Y-C, Cheng C-H, Tsau Y-K (2007) Early postnatal renal growth in premature infants. Nephrology (Carlton) 12:572–575CrossRef Huang H-P, Tsai IJ, Lai Y-C, Cheng C-H, Tsau Y-K (2007) Early postnatal renal growth in premature infants. Nephrology (Carlton) 12:572–575CrossRef
30.
go back to reference Laterza OF, Price CP, Scott MG (2002) Cystatin C: an improved estimator of glomerular filtration rate? Clin Chem 48:699–707PubMed Laterza OF, Price CP, Scott MG (2002) Cystatin C: an improved estimator of glomerular filtration rate? Clin Chem 48:699–707PubMed
31.
go back to reference Roos JF, Doust J, Tett SE, Kirkpatrick CM (2007) Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children–a meta-analysis. Clin Biochem 40:383–391PubMedCrossRef Roos JF, Doust J, Tett SE, Kirkpatrick CM (2007) Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children–a meta-analysis. Clin Biochem 40:383–391PubMedCrossRef
32.
go back to reference Gubhaju L, Sutherland MR, Yoder BA, Zulli A, Bertram JF, Black MJ (2009) Is nephrogenesis affected by preterm birth? Studies in a non-human primate model. Am J Physiol Ren Physiol 297:F1668–F1677CrossRef Gubhaju L, Sutherland MR, Yoder BA, Zulli A, Bertram JF, Black MJ (2009) Is nephrogenesis affected by preterm birth? Studies in a non-human primate model. Am J Physiol Ren Physiol 297:F1668–F1677CrossRef
33.
go back to reference Cataldi L, Mussap M, Bertelli L, Ruzzante N, Fanos V, Plebani M (1999) Cystatin C in healthy women at term pregnancy and in their infant newborns: relationship between maternal and neonatal serum levels and reference values. Am J Perinatol 16:287–295PubMedCrossRef Cataldi L, Mussap M, Bertelli L, Ruzzante N, Fanos V, Plebani M (1999) Cystatin C in healthy women at term pregnancy and in their infant newborns: relationship between maternal and neonatal serum levels and reference values. Am J Perinatol 16:287–295PubMedCrossRef
34.
go back to reference Finney H, Newman DJ, Thakkar H, Fell JM, Price CP (2000) Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. Arch Dis Child 82:71–75PubMedCrossRef Finney H, Newman DJ, Thakkar H, Fell JM, Price CP (2000) Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. Arch Dis Child 82:71–75PubMedCrossRef
35.
go back to reference Bariciak E, Yasin A, Harrold J, Walker M, Lepage N, Filler G (2011) Preliminary reference intervals for cystatin C and beta-trace protein in preterm and term neonates. Clin Biochem 44:1156–1159PubMedCrossRef Bariciak E, Yasin A, Harrold J, Walker M, Lepage N, Filler G (2011) Preliminary reference intervals for cystatin C and beta-trace protein in preterm and term neonates. Clin Biochem 44:1156–1159PubMedCrossRef
36.
go back to reference Harmoinen A, Ylinen E, Ala-Houhala M, Janas M, Kaila M, Kouri T (2000) Reference intervals for cystatin C in pre- and full-term infants and children. Pediatr Nephrol 15:105–108PubMedCrossRef Harmoinen A, Ylinen E, Ala-Houhala M, Janas M, Kaila M, Kouri T (2000) Reference intervals for cystatin C in pre- and full-term infants and children. Pediatr Nephrol 15:105–108PubMedCrossRef
37.
go back to reference Gubhaju L, Black MJ (2005) The baboon as a good model for studies of human kidney development. Pediatr Res 58:505–509PubMedCrossRef Gubhaju L, Black MJ (2005) The baboon as a good model for studies of human kidney development. Pediatr Res 58:505–509PubMedCrossRef
38.
go back to reference Miller SS, Lee HC, Gould JB (2012) Hypothermia in very low birth weight infants: distribution, risk factors and outcomes. J Perinatol 31(Suppl 1):S49–S56 Miller SS, Lee HC, Gould JB (2012) Hypothermia in very low birth weight infants: distribution, risk factors and outcomes. J Perinatol 31(Suppl 1):S49–S56
Metadata
Title
Extra-uterine renal growth in preterm infants: Oligonephropathy and prematurity
Authors
Yogavijayan Kandasamy
Roger Smith
Ian M. R. Wright
Eugenie R. Lumbers
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 9/2013
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-013-2462-3

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