Tamaño renal, presión arterial, microalbuminuria y filtración glomerular son aconsejables controlar en el seguimiento de niños nacidos prematuros
Keywords:
premature, arterial hypertension, kidney measurements, renal function, microalbuminuria
Abstract
Introduction: Children born prematurely grow up with risk of kidney damage. Objectives: To study blood pressure, glomerular filtration, microalbuminuria/creatininuria ratio and kidney size in preterm infants to determine the prevalence of high blood pressure and alterations in other variables. To associate kidney size with the variables studied. Methods: Prospective, cross-sectional study. Population: preterm infants and a group of full term newborns (controls). Period: July/2017 to July/2018. Inclusion: outpatient premature infants with gestational age ≤ 32 weeks, birth weight ≤ 1,500 g, ≥ 1 to ≤ 7 years. The following factors were studied: perinatal data, blood pressure and renal function at the time of ultrasound control. Length, antero-posterior and transverse diameters were measured in both kidneys through sonography. Relative length, absolute volume, relative volume and predictive volume were calculated. A descriptive and inferential analysis was carried out. Results: 43 premature infants and 21 controls were studied, their mean age being 4.42 and 3.9 years, respectively. Systolic hypertension was observed in 21% of cases and diastolic hypertension in 37%; altered glomerular filtration was found in 74%; altered microalbuminuria/creatinine ratio was determined in 80%. The mean length was shorter than controls in 53% of preterm infants and it was lower than the Rosenbaum mean values in 86%. The mean volume was lower than controls in 58% of preterm infant as well as the predictive volume in 45% of them. Conclusion: Children born prematurely, aged between 1 and 7, presented a high frequency of high blood pressure, glomerular filtration and pathological microalbuminuria/creatinine ratio, as well as lengths and volumes different from the reference values. These could be considered risk factors for kidney health in preterm infants.
References
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25) Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989;5(5):303-11; discussion 312-3.
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27) O'Neill WC. Sonographic evaluation of renal failure. Am J Kidney Dis. 2000;35(6):1021-38. doi: 10.1016/s0272-6386(00)70036-9.
28) Hodgin JB, Rasoulpour M, Markowitz GS, D'Agati VD. Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2009;4(1):71-6. doi: 10.2215/CJN.01700408.
29) Bonamy AK, Bendito A, Martin H, Andolf E, Sedin G, Norman M. Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res. 2005;58(5):845-9. doi: 10.1203/01.PDR.0000181373.29290.80.
30) Siewert-Delle A, Ljungman S. The impact of birth weight and gestational age on blood pressure in adult life: a population-based study of 49-year-old men. Am J Hypertens. 1998;11(8 Pt 1):946-53. doi: 10.1016/s0895-7061(98)00090-9.
31) Cooper R, Atherton K, Power C. Gestational age and risk factors for cardiovascular disease: evidence from the 1958 British birth cohortfollowed to mid-life. Int J Epidemiol. 2009;38(1):235-44. doi: 10.1093/ije/dyn154.
32) Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med. 1995;155(7):701-9.
33) Huang HP, Tsai IJ, Lai YC, Cheng CH, Tsau YK. Early postnatal renal growth in premature infants. Nephrology (Carlton). 2007;12(6):572-5. doi: 10.1111/j.1440-1797.2007.00882.x.
34) Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE. Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol. 2004;7(1):17-25. doi: 10.1007/s10024-003-3029-2.
35) Singh GR, Hoy WE. Kidney volume, blood pressure, and albuminuria: findings in an Australian aboriginal community. Am J Kidney Dis. 2004;43(2):254-9. doi: 10.1053/j.ajkd.2003.10.015.
36) Zanardo V, Fanelli T, Weiner G, Fanos V, Zaninotto M, Visentin S, et al. Intrauterine growth restriction is associated with persistent aortic wall thickening and glomerular proteinuria during infancy. Kidney Int. 2011;80(1):119-23. doi: 10.1038/ki.2011.99.
37) Keijzer-Veen MG, Schrevel M, Finken MJ, Dekker FW, Nauta J, Hille ET, et al. Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol. 2005;16(9):2762-8. doi: 10.1681/ASN.2004090783.
38) Keijzer-Veen MG, Devos AS, Meradji M, Dekker FW, Nauta J, van der Heijden BJ. Reduced renal length and volume 20 years after very preterm birth. Pediatr Nephrol. 2010;25(3):499-507. doi: 10.1007/s00467-009-1371-y.
39) Drougia A, Giapros V, Hotoura E, Papadopoulou F, Argyropoulou M, Andronikou S. The effects of gestational age and growth restriction on compensatory kidney growth. Nephrol Dial Transplant. 2009;24(1):142-8. doi: 10.1093/ndt/gfn431.
40) Rakow A, Johansson S, Legnevall L, Sevastik R, Celsi G, Norman M, et al. Renal volume and function in school-age children born preterm or small for gestational age. Pediatr Nephrol. 2008;23(8):1309-15. doi: 10.1007/s00467-008-0824-z.
41) Starzec K, Klimek M, Grudzień A, Jagła M, Kwinta P. Longitudinal assessment of renal size and function in extremely ow birth weight children at 7 and 11 years of age. Pediatr Nephrol. 2016;31(11):2119-26. doi: 10.1007/s00467-016-3413-6.
42) Vanpée M, Blennow M, Linné T, Herin P, Aperia A. Renal function in very low birth weight infants: normal maturity reached during early childhood. J Pediatr. 1992;121(5 Pt 1):784-8. doi: 10.1016/s0022-3476(05)81916-x.
2) Bacchetta J, Harambat J, Guy B, Putet G, Cochat P, Dubourg L. Devenir rénal des enfants nés grands prématurés: un suivi simple mais régulier est nécessaire. Arch Pediatr. 2009;16(Suppl. 1):S42-8. doi: 10.1016/S0929-693X(09)75300-X.
3) Brenner BM, Chertow GM. Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis. 1994;23(2):171-5. doi: 10.1016/S0272-6386(12)80967-X.
4) Barker DJ, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993;341(8850):938-41. doi: 10.1016/0140-6736(93)91224-a.
5) Hoy WE, Rees M, Kile E, Mathews JD, Wang Z. A new dimension to the Barker hypothesis: low birthweight and susceptibility to renal disease. Kidney Int. 1999;56(3):1072-7. doi: 10.1046/j.1523-1755.1999.00633.x.
6) Schmidt IM, Chellakooty M, Boisen KA, Damgaard IN, Mau Kai C, Olgaard K, et al. Impaired kidney growth in low-birth-weight children: distinct effects of maturity and weight for gestational age. Kidney Int. 2005;68(2):731-40. doi: 10.1111/j.1523-1755.2005.00451.x.
7) Law CM, Shiell AW. Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. J Hypertens. 1996;14(8):935-41.
8) Rodríguez-Soriano J, Aguirre M, Oliveros R, Vallo A. Long-term renal follow-up of extremely low birth weight infants. Pediatr Nephrol. 2005;20(5):579-84. doi: 10.1007/s00467-005-1828-6.
9) Kistner A, Celsi G, Vanpee M, Jacobson SH. Increased blood pressure but normal renal function in adult women born preterm. Pediatr Nephrol. 2000;15(3-4):215-20. doi: 10.1007/s004670000473.
10) Abitbol CL, Chandar J, Rodríguez MM, Berho M, Seeherunvong W, Freundlich M, et al. Obesity and preterm birth: additive risks in the progression of kidney disease in children. Pediatr Nephrol. 2009;24(7):1363-70. doi: 10.1007/s00467-009-1120-2.
11) Rahiala E, Tenhola S, Vanninen E, Herrgård E, Tikanoja T, Martikainen A. Ambulatory blood pressure in 12-year-old children born small for gestational age. Hypertension. 2002;39(4):909-13. doi: 10.1161/01.hyp.0000013864.24138.a5.
12) Miceli S, Rodríguez L, Cossio J, Rojas S, Pérez Z, Caram ME, et al. Análisis de los registros de presión arterial en recién nacidos pretérminos en consultorio de control ambulatorio. Rev Med Tucumán. 2011;17(3):20-8.
13) Miceli S, Rodríguez L, Martinini M, Caram M, Pérez M, Djivelekian M, et al. Medias de presión arterial en una población de niños prematuros con peso extremadamente bajo, en controles ambulatorio. V Congreso Argentino de Nefrología Pediátrica (Buenos Aires: 21-23 jun. 2012). [Premio al Trabajo de Investigación Clínica].
14) Martinini MI, Caram ME, Zaira Pérez M, Djivelekian M, Santana M, Miceli S. Cohorte de prematuros de alto riesgo hasta los 24 meses: crecimiento y desarrollo. Rev Fac Med. [Universidad Nacional de Tucuman] 2016;16(1):4-14.
15) Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013;13:59. doi: 10.1186/1471-2431-13-59.
16) Fustiñana CA, Rodríguez D, Mariani G. Evaluación posalta del crecimiento en prematuros. Implicaciones de adoptar las curvas OMS. Arch Argent Pediatr. 2014;112(2):141-6. doi: 10.5546/aap.2014.141.
17) Report of the Second Task Force on Blood Pressure Control in Children--1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics. 1987;79(1):1-25.
18) National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl. 4th Report):555-76.
19) Flynn JT, Falkner BE. New clinical practice guideline for the management of high blood pressure in children and adolescents. Hypertension. 2017;70(4):683-6. doi: 10.1161/HYPERTENSIONAHA.117.10050.
20) Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629-37. doi: 10.1681/ASN.2008030287.
21) Toto RD. Microalbuminuria: definition, detection, and clinical significance. J Clin Hypertens (Greenwich). 2004;6(11 Suppl. 3):2-7. doi: 10.1111/j.1524-6175.2004.4064.x.
22) Rosenbaum DM, Korngold E, Teele RL. Sonographic assessment of renal length in normal children. AJR Am J Roentgenol. 1984;142(3):467-9. doi: 10.2214/ajr.142.3.467.
23) Zenkl M, Egghart G, Müller M. Normale Nierengrössen bei Kindern. Eine sonographische Studie [The normal kidney size in children. An ultrasound study]. Urologe A. 1990;29(1):32-8.
24) Schmidt IM, Main KM, Damgaard IN, Mau C, Haavisto AM, Chellakooty M, et al. Kidney growth in 717 healthy children aged 0-18 months: a longitudinal cohort study. Pediatr Nephrol. 2004;19(9):992-1003. doi: 10.1007/s00467-004-1479-z.
25) Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989;5(5):303-11; discussion 312-3.
26) Kwinta P, Klimek M, Drozdz D, Grudzień A, Jagła M, Zasada M, et al. Assessment of long-term renal complications in extremely low birth weight children. Pediatr Nephrol. 2011;26(7):1095-103. doi: 10.1007/s00467-011-1840-y.
27) O'Neill WC. Sonographic evaluation of renal failure. Am J Kidney Dis. 2000;35(6):1021-38. doi: 10.1016/s0272-6386(00)70036-9.
28) Hodgin JB, Rasoulpour M, Markowitz GS, D'Agati VD. Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2009;4(1):71-6. doi: 10.2215/CJN.01700408.
29) Bonamy AK, Bendito A, Martin H, Andolf E, Sedin G, Norman M. Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res. 2005;58(5):845-9. doi: 10.1203/01.PDR.0000181373.29290.80.
30) Siewert-Delle A, Ljungman S. The impact of birth weight and gestational age on blood pressure in adult life: a population-based study of 49-year-old men. Am J Hypertens. 1998;11(8 Pt 1):946-53. doi: 10.1016/s0895-7061(98)00090-9.
31) Cooper R, Atherton K, Power C. Gestational age and risk factors for cardiovascular disease: evidence from the 1958 British birth cohortfollowed to mid-life. Int J Epidemiol. 2009;38(1):235-44. doi: 10.1093/ije/dyn154.
32) Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med. 1995;155(7):701-9.
33) Huang HP, Tsai IJ, Lai YC, Cheng CH, Tsau YK. Early postnatal renal growth in premature infants. Nephrology (Carlton). 2007;12(6):572-5. doi: 10.1111/j.1440-1797.2007.00882.x.
34) Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE. Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol. 2004;7(1):17-25. doi: 10.1007/s10024-003-3029-2.
35) Singh GR, Hoy WE. Kidney volume, blood pressure, and albuminuria: findings in an Australian aboriginal community. Am J Kidney Dis. 2004;43(2):254-9. doi: 10.1053/j.ajkd.2003.10.015.
36) Zanardo V, Fanelli T, Weiner G, Fanos V, Zaninotto M, Visentin S, et al. Intrauterine growth restriction is associated with persistent aortic wall thickening and glomerular proteinuria during infancy. Kidney Int. 2011;80(1):119-23. doi: 10.1038/ki.2011.99.
37) Keijzer-Veen MG, Schrevel M, Finken MJ, Dekker FW, Nauta J, Hille ET, et al. Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol. 2005;16(9):2762-8. doi: 10.1681/ASN.2004090783.
38) Keijzer-Veen MG, Devos AS, Meradji M, Dekker FW, Nauta J, van der Heijden BJ. Reduced renal length and volume 20 years after very preterm birth. Pediatr Nephrol. 2010;25(3):499-507. doi: 10.1007/s00467-009-1371-y.
39) Drougia A, Giapros V, Hotoura E, Papadopoulou F, Argyropoulou M, Andronikou S. The effects of gestational age and growth restriction on compensatory kidney growth. Nephrol Dial Transplant. 2009;24(1):142-8. doi: 10.1093/ndt/gfn431.
40) Rakow A, Johansson S, Legnevall L, Sevastik R, Celsi G, Norman M, et al. Renal volume and function in school-age children born preterm or small for gestational age. Pediatr Nephrol. 2008;23(8):1309-15. doi: 10.1007/s00467-008-0824-z.
41) Starzec K, Klimek M, Grudzień A, Jagła M, Kwinta P. Longitudinal assessment of renal size and function in extremely ow birth weight children at 7 and 11 years of age. Pediatr Nephrol. 2016;31(11):2119-26. doi: 10.1007/s00467-016-3413-6.
42) Vanpée M, Blennow M, Linné T, Herin P, Aperia A. Renal function in very low birth weight infants: normal maturity reached during early childhood. J Pediatr. 1992;121(5 Pt 1):784-8. doi: 10.1016/s0022-3476(05)81916-x.
Published
2021-03-25
How to Cite
1.
Rodríguez LI, Miceli SC, D’Urso Villar M, Maurizi M, Caram ME, Pérez MZ, Martinini MI. Tamaño renal, presión arterial, microalbuminuria y filtración glomerular son aconsejables controlar en el seguimiento de niños nacidos prematuros. Rev Nefrol Dial Traspl. [Internet]. 2021Mar.25 [cited 2024Jul.16];41(1):9-22. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/610
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