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Molecular and Cellular Pediatrics
Published in: Molecular and Cellular Pediatrics 1/2017

Open Access 01-12-2017 | Review

Renal consequences of preterm birth

Authors: Amelie Stritzke, Sumesh Thomas, Harish Amin, Christoph Fusch, Abhay Lodha

Published in: Molecular and Cellular Pediatrics | Issue 1/2017

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Abstract

Background

The developmental origin of health and disease concept identifies the brain, cardiovascular, liver, and kidney systems as targets of fetal adverse programming with adult consequences. As the limits of viability in premature infants have been pushed to lower gestational ages, the long-term impact of prematurity on kidneys still remains a significant burden during hospital stay and beyond.

Objectives

The purpose of this study is to summarize available evidence, mechanisms, and short- and long-term renal consequences of prematurity and identify nephroprotective strategies and areas of uncertainty.

Results

Kidney size and nephron number are known to be reduced in surviving premature infants due to disruption of organogenesis at a crucial developmental time point. Inflammation, hyperoxia, and antiangiogenic factors play a role in epigenetic conditioning with potential life-long consequences. Additional kidney injury from hypoperfusion and nephrotoxicity results in structural and functional changes over time which are often unnoticed. Nephropathy of prematurity and acute kidney injury confound glomerular and tubular maturation of preterm kidneys. Kidney protective strategies may ameliorate growth failure and suboptimal neurodevelopmental outcomes in the short term. In later life, subclinical chronic renal disease may progress, even in asymptomatic survivors.

Conclusion

Awareness of renal implications of therapeutic interventions and renal conservation efforts may lead to a variety of short and long-term benefits. Adequate monitoring and supplementation of microelement losses, gathering improved data on renal handling, and exploration of new avenues such as reliable markers of injury and new therapeutic strategies in contemporary populations, as well as long-term follow-up of renal function, is warranted.
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Metadata
Title
Renal consequences of preterm birth
Authors
Amelie Stritzke
Sumesh Thomas
Harish Amin
Christoph Fusch
Abhay Lodha
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Molecular and Cellular Pediatrics / Issue 1/2017
Electronic ISSN: 2194-7791
DOI
https://doi.org/10.1186/s40348-016-0068-0

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