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Konopásek P, Skálová S, Sládková E, Pecková M, Flachsová E, Urbanová I, Laubová J, Samešová M, Dvořák P, Zieg J. Low Birth Weight is Associated with More Severe Course of Steroid-Sensitive Nephrotic Syndrome in Children, Multicentric Study. Klin Padiatr 2024. [PMID: 38320582 DOI: 10.1055/a-2227-4892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Several previous studies have reported a more severe course of nephrotic syndrome in children with low birth weight. PATIENTS Cohort of 223 children with idiopathic nephrotic syndrome. METHODS We aimed to investigate the association between course of nephrotic syndrome and low birth weight. Data from seven paediatric nephrology centres were used. RESULTS Children with low birth weight had 3.84 times higher odds for a more severe course of steroid-sensitive nephrotic syndrome (95% CI 1.20-17.22, P=0.041), and those with low birth weight and remission after 7 days had much higher odds for a more severe course of disease (OR 8.7). Low birth weight children had a longer time to remission (median 12 vs. 10 days, P=0.03). They had a higher need for steroid-sparing agents (OR for the same sex=3.26 [95% CI 1.17-11.62, P=0.039]), and the odds were even higher in females with low birth weight (OR 6.81). There was no evidence of an association either between low birth weight and focal segmental glomerulosclerosis or between low birth weight and steroid-resistant nephrotic syndrome. DISCUSSION We conducted the first multicentric study confirming the worse outcomes of children with NS and LBW and we found additional risk factors. CONCLUSIONS Low birth weight is associated with a more severe course of steroid-sensitive nephrotic syndrome, while being female and achieving remission after 7 days are additional risk factors.
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Affiliation(s)
- Patrik Konopásek
- Pediatric Nephrology, Motol University Hospital, Praha, Czech Republic
| | - Sylva Skálová
- Pediatrics, Fakultní Nemocnice Hradec Králové, Hradec Kralove, Czech Republic
| | - Eva Sládková
- Pediatrics, Fakultní nemocnice Plzeň, Plzen, Czech Republic
| | - Monika Pecková
- Institute of Applied Mathematics and Information Technologies, Univerzita Karlova Přírodovědecká fakulta, Praha, Czech Republic
| | - Eva Flachsová
- Pediatrics, Motol University Hospital, Praha, Czech Republic
| | | | - Jana Laubová
- Pediatrics, Univerzita Jana Evangelisty Purkyně v Ústí nad Labem, Usti nad Labem, Czech Republic
| | - Martina Samešová
- Pediatrics, Univerzita Jana Evangelisty Purkyně v Ústí nad Labem, Usti nad Labem, Czech Republic
| | - Pavel Dvořák
- Pediatrics, Všeobecná fakultní nemocnice v Praze, Praha, Czech Republic
| | - Jakub Zieg
- Department of Pediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Prague, Czech Republic
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Kanbay M, Copur S, Yildiz AB, Covic A, Covic A, Ciceri P, Magagnoli L, Cozzolino M. Intrauterine life to adulthood: a potential risk factor for chronic kidney disease. Nephrol Dial Transplant 2023; 38:2675-2684. [PMID: 37370229 DOI: 10.1093/ndt/gfad134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Indexed: 06/29/2023] Open
Abstract
Multiple risk factors for chronic kidney disease (CKD), one of the major causes of morbidity and mortality in the adult population globally, have been identified, including older age, male gender, family history, smoking, diabetes mellitus, hypertension, ischaemic heart diseases and various medications. Preterm delivery, affecting >10% of the newborns in the USA, is a global concern with increasing incidence in recent decades. Preterm birth has been linked to multiple medical comorbidities such as diabetes mellitus, hypertension and cardiovascular diseases, while its association with CKD has recently been investigated. Prematurity and intrauterine growth restriction (IUGR) have been associated with an increased risk for CKD, specific histopathological examination findings and CKD-associated risk factors such as diabetes mellitus, hypertension and dyslipidaemia. In this narrative review, our aim is to evaluate and summarize the association between the risk for CKD and prematurity, low birthweight and IUGR along with potential underlying pathophysiological mechanisms.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Abdullah B Yildiz
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Andreea Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Adrian Covic
- Department of Nephrology, Grigore T. Popa' University of Medicine, Iasi, Romania
| | - Paola Ciceri
- Department of Health Sciences, Renal Division, University of Milan, Milan, Italy
| | - Lorenza Magagnoli
- Department of Health Sciences, Renal Division, University of Milan, Milan, Italy
| | - Mario Cozzolino
- Department of Health Sciences, Renal Division, University of Milan, Milan, Italy
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Hingorani S, Gibson KL, Xie Y, Wang Y, Eddy S, Hartman J, Sampson M, Cassol C, Thomas D, Gipson DS, Trachtman H, Srivastava T, Reidy K. The association of low birthweight and prematurity on outcomes in children and adults with nephrotic syndrome-a NEPTUNE cohort study. Pediatr Nephrol 2023; 38:3297-3308. [PMID: 37140708 DOI: 10.1007/s00467-023-05876-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/22/2022] [Accepted: 12/22/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND In single-center studies, both preterm birth and low birth weight (LBW) are associated with worse outcomes in childhood nephrotic syndrome. Using the Nephrotic Syndrome Study Network (NEPTUNE) observational cohort, we tested the hypothesis that in patients with nephrotic syndrome, hypertension, proteinuria status, and disease progression would be more prevalent and more severe in subjects with LBW and prematurity singly or in combination (LBW/prematurity). METHODS Three hundred fifty-nine adults and children with focal segmental glomerulosclerosis (FSGS) or minimal change disease (MCD) and available birth history were included. Estimated glomerular filtration rate (eGFR) decline and remission status were primary outcomes, and secondary outcomes were kidney histopathology, kidney gene expression, and urinary biomarkers. Logistic regression was used to identify associations with LBW/prematurity and these outcomes. RESULTS We did not find an association between LBW/prematurity and remission of proteinuria. However, LBW/prematurity was associated with greater decline in eGFR. This decline in eGFR was partially explained by the association of LBW/prematurity with APOL1 high-risk alleles, but the association remained after adjustment. There were no differences in kidney histopathology or gene expression in the LBW/prematurity group compared to normal birth weight/term birth. CONCLUSION LBW and premature babies who develop nephrotic syndrome have a more rapid decline in kidney function. We did not identify clinical or laboratory features that distinguished the groups. Additional studies in larger groups are needed to fully ascertain the effects of (LBW) and prematurity alone or in combination on kidney function in the setting of nephrotic syndrome.
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Affiliation(s)
- Sangeeta Hingorani
- University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
| | | | - Yuping Xie
- Department of Pediatrics/Nephrology Bronx, Children's Hospital at Montefiore/Einstein, The Bronx, NY, USA
| | - Yujie Wang
- Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Sean Eddy
- Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - John Hartman
- Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Matthew Sampson
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Broad Institute, Cambridge, MA, USA
| | | | | | - Debbie S Gipson
- Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Howard Trachtman
- Department of Pediatrics, Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Tarak Srivastava
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Kimberly Reidy
- Department of Pediatrics/Nephrology Bronx, Children's Hospital at Montefiore/Einstein, The Bronx, NY, USA
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Brathwaite KE, Levy RV, Sarathy H, Agalliu I, Johns TS, Reidy KJ, Fadrowski JJ, Schwartz GJ, Kaskel FJ, Melamed ML. Reduced kidney function and hypertension in adolescents with low birth weight, NHANES 1999-2016. Pediatr Nephrol 2023; 38:3071-3082. [PMID: 37052695 DOI: 10.1007/s00467-023-05958-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is a major health problem, and the risk of CKD and hypertension in children born low birth weight (LBW) is under-recognized. We hypothesized that children born with LBW would have a higher prevalence of reduced kidney function and hypertension. METHODS Using the National Health and Nutrition Examination Survey (NHANES), we conducted a cross-sectional study to evaluate whether LBW (< 2500 g), very low birth weight (VLBW < 1500 g), and large birth weight (BW) (> 4000 g) were associated with kidney disease using 4 different estimating equations. We used the Counahan-Barratt, updated Schwartz, CKiD-U25, and full age spectrum creatinine-based GFR estimating equations to evaluate associations between a history of LBW/VLBW/large BW and reduced kidney function (eGFR < 90 mL/min/1.73 m2) in children. We also assessed blood pressure (BP) using the old and new pediatric hypertension guidelines. RESULTS Our analysis included 6336 children (age 12-15 years) in NHANES representing over 13 million US individuals. Using the updated Schwartz, the prevalence of reduced kidney function was 30.1% (25.2-35.6) for children born with LBW compared to 22.4% (20.5-24.3) in children with normal BW. Equations yielded different estimates of prevalence of reduced kidney function in LBW from 21.5% for Counahan-Barratt to 35.4% for CKiD-U25. Compared to those with normal BW, participants with LBW and VLBW had a 7.2 and 10.3% higher prevalence of elevated BP and a 2.4 and 14.6% higher prevalence of hypertension, respectively. CONCLUSIONS Children born with LBW are at higher risk of reduced kidney function and hypertension than previously described. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Kaye E Brathwaite
- Pediatric Nephrology, Washington University in St. Louis, MO, St. Louis, USA.
| | - Rebecca V Levy
- Division of Nephrology, Department of Internal Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Division of Nephrology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Harini Sarathy
- UCSF at Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Ilir Agalliu
- Dept. of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tanya S Johns
- Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | - Kimberly J Reidy
- Division of Pediatric Nephrology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Jeffrey J Fadrowski
- Division of Pediatric Nephrology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - George J Schwartz
- Division of Nephrology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Frederick J Kaskel
- Division of Pediatric Nephrology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Michal L Melamed
- Dept. of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
- Division of Pediatric Nephrology, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA
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Williams AE, Esezobor CI, Lane BM, Gbadegesin RA. Hiding in plain sight: genetics of childhood steroid-resistant nephrotic syndrome in Sub-Saharan Africa. Pediatr Nephrol 2023; 38:2003-2012. [PMID: 36459247 PMCID: PMC10416081 DOI: 10.1007/s00467-022-05831-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
Steroid-resistant nephrotic syndrome (SRNS) is the most severe form of childhood nephrotic syndrome with an increased risk of progression to chronic kidney disease stage 5. Research endeavors to date have identified more than 80 genes that are associated with SRNS. Most of these genes regulate the structure and function of the podocyte, the visceral epithelial cells of the glomerulus. Although individuals of African ancestry have the highest prevalence of SRNS, especially those from Sub-Saharan Africa (SSA), with rates as high as 30-40% of all cases of nephrotic syndrome, studies focusing on the characterization and understanding of the genetic basis of SRNS in the region are negligible compared with Europe and North America. Therefore, it remains unclear if some of the variants in SRNS genes that are deemed pathogenic for SRNS are truly disease causing, and if the leading causes of monogenic nephrotic syndrome in other populations are the same for children in SSA with SRNS. Other implications of this lack of genetic data for SRNS in the region include the exclusion of children from the region from clinical trials aimed at identifying potential novel therapeutic agents for this severe form of nephrotic syndrome. This review underlines a need for concerted efforts to advance the genetic basis of SRNS in children in SSA. Such endeavors will complement global efforts at understanding the genetic basis of nephrotic syndrome.
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Affiliation(s)
- Anna Elizabeth Williams
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Christopher I Esezobor
- Department of Pediatrics, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Brandon M Lane
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, 27710, USA
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
| | - Rasheed A Gbadegesin
- Department of Pediatrics, Division of Nephrology, Duke University Medical Center, Durham, NC, 27710, USA.
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA.
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Du S, Bai S, Zhao X, Lin S, Zhai Y, Wang Z, Wang Z. The effect and its critical window for ambient temperature and humidity in pregnancy on term low birth weight. Environ Sci Pollut Res Int 2022; 29:54531-54542. [PMID: 35301630 DOI: 10.1007/s11356-022-19512-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
As common meteorological factors in daily life, there is limited evidence for the effect of ambient temperature and humidity during pregnancy on the risk of term low birth weight. Furthermore, little is known about the interaction of ambient temperature and humidity on TLBW. The objective of the study was to explore the effect of ambient temperature, humidity during pregnancy, and their interaction on the risk of TLBW and, moreover, to identify exposure critical window. We recruited 6640 infants and their mothers to build a birth cohort study in Jinan City, China, from January 2018 to December 2019. The associations between temperature and humidity during pregnancy and TLBW were estimated by generalized additive model, logistic regression model, and interaction analysis, and the critical window was identified by the distributed lag non-linear model. The incidence of TLBW was 1.36% for the infants in the birth cohort. TLBW was related to the low level of temperature and humidity in the whole pregnancy, compared with the moderate level and the adjusted ORs were 4.44 (1.65-11.42) and 6.23 (1.92-21.39), respectively. The indicators of the interaction analysis of temperature and humidity were not statistically significant. For the low level of humidity, the association with TLBW was statistically significant at first to sixth gestational weeks, and the maximum OR in male infants (3.95, 1.70-9.16) was higher than that in females (1.96, 1.06-3.63). For the low level of temperature, we failed to find significant association with TLBW at each gestational week. The low level of temperature and humidity during pregnancy could increase the risk of TLBW. There was no statistical interaction between temperature and humidity on TLBW. Moreover, the early stage of pregnancy was the critical window for humidity exposure, in which the boys had a greater effect.
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Affiliation(s)
- Shuang Du
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Shuoxin Bai
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong, 250012, People's Republic of China
| | - Xiaodong Zhao
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China
| | - Shaoqian Lin
- Jinan Municipal Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China
| | - Yifan Zhai
- Department of Occupational and Environmental Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Zhaojun Wang
- Shandong Jinan Ecological Environment Monitoring Center, Jinan, Shandong, People's Republic of China
| | - Zhiping Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, Shandong, 250012, People's Republic of China.
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Flahault A, Bollée G, El-Jalbout R, Cloutier A, Santos RAS, Lapeyraque AL, Luu TM, Nuyt AM. Plasma copeptin is increased and associated with smaller kidney volume in young adults born very preterm. Clin Kidney J 2021; 15:709-717. [PMID: 35371457 PMCID: PMC8967663 DOI: 10.1093/ckj/sfab226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background Plasma copeptin, a surrogate marker for vasopressin levels, is increased in neonates born preterm, particularly in those with a more severe neonatal course, as reflected by bronchopulmonary dysplasia. Copeptin levels in adulthood are unknown. Methods In this case–control study of 101 adults born very preterm (<30 weeks of gestation) and 105 control adults born full-term, a comprehensive clinical and biological assessment was performed, including blood pressure measurements, kidney ultrasound and determination of plasma copeptin, renin activity, angiotensin II, aldosterone, apelin, sodium and potassium, serum and morning urine osmolality. Results The median age in the study was 23.1 years [interquartile range (IQR) 21.2–24.8] and 57% were females. In males, the median copeptin levels were 8.2 pmol/L (IQR 6.3–12.4) and 6.1 pmol/L (IQR 4.3–9.0) in the preterm and term groups, respectively (P = 0.022). In females, the median copeptin levels were 5.2 pmol/L (IQR 3.9–7.6) and 4.0 pmol/L (IQR 2.8–5.7) in the preterm and term groups, respectively (P = 0.005). Adults born preterm with a history of bronchopulmonary dysplasia had further increased copeptin levels. The kidney volume, adjusted for height, was smaller and albuminuria was higher in the preterm group, and both were associated with higher plasma copeptin levels. Conclusions Plasma copeptin is higher in young adults born preterm and is related to a more severe neonatal course and smaller kidney volume.
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Affiliation(s)
- Adrien Flahault
- Sainte-Justine University Hospital Research Center, Université de Montréal, Montréal, Québec, Canada
| | - Guillaume Bollée
- Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Ramy El-Jalbout
- Sainte-Justine University Hospital Research Center, Université de Montréal, Montréal, Québec, Canada
- Medical Imaging Department, Sainte-Justine University Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Anik Cloutier
- Sainte-Justine University Hospital Research Center, Université de Montréal, Montréal, Québec, Canada
| | - Robson A S Santos
- Department of Physiology and Biophysics, National Institute of Science and Technology in Nanobiopharmaceutics (INCT-Nanobiofar), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Anne-Laure Lapeyraque
- Sainte-Justine University Hospital Research Center, Université de Montréal, Montréal, Québec, Canada
- Division of Nephrology, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Thuy Mai Luu
- Sainte-Justine University Hospital Research Center, Université de Montréal, Montréal, Québec, Canada
- Division of General Pediatrics, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Anne Monique Nuyt
- Sainte-Justine University Hospital Research Center, Université de Montréal, Montréal, Québec, Canada
- Division of Neonatology, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montréal, Québec, Canada
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Chen CC, Yu T, Chou HH, Chiou YY, Kuo PL. Premature birth carries a higher risk of nephrotic syndrome: a cohort study. Sci Rep 2021; 11:20639. [PMID: 34667222 PMCID: PMC8526683 DOI: 10.1038/s41598-021-00164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/06/2021] [Indexed: 11/09/2022] Open
Abstract
The pathogenesis of nephrotic syndrome is unclear. We conducted a nationwide population-based cohort study to examine the associations between preterm births and subsequent development of NS. NS was defined as ≥ 3 records with ICD-9-CM codes for NS in hospital admission or outpatient clinic visits. To avoid secondary nephrotic syndrome or nephritis with nephrotic range proteinuria, especially IgA nephropathy, we excluded patients with associated codes. A total of 78,651 preterm infants (gestational age < 37 weeks) and 786,510 matched term infants born between 2004 and 2009 were enrolled and followed until 2016. In the unadjusted models, preterm births, maternal diabetes, and pregnancy induced hypertension were associated with subsequent NS. After adjustment, preterm births remained significantly associated with NS (p = 0.001). The risk of NS increased as the gestational age decreased (p for trend < 0.001). Among the NS population, preterm births were not associated with more complications (Hypertension: p = 0.19; Serious infections: p = 0.63, ESRD: p = 0.75) or a requirement for secondary immunosuppressants (p = 0.61). In conclusion, preterm births were associated with subsequent NS, where the risk increased as the gestational age decreased. Our study provides valuable information for future pathogenesis studies.
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Affiliation(s)
- Chih-Chia Chen
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Division of Pediatric Nephrology, Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-Hsu Chou
- Department of Pediatrics, Ditmanson Medical Foundation, Chiayi Christian Hospital, Chia-Yi City, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Yuan-Yow Chiou
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. .,Division of Pediatric Nephrology, Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan.
| | - Pao-Lin Kuo
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan.
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Hoogenboom LA, Wolfs TGAM, Hütten MC, Peutz-Kootstra CJ, Schreuder MF. Prematurity, perinatal inflammatory stress, and the predisposition to develop chronic kidney disease beyond oligonephropathy. Pediatr Nephrol 2021; 36:1673-1681. [PMID: 32880745 PMCID: PMC8172498 DOI: 10.1007/s00467-020-04712-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/28/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022]
Abstract
Prematurity and perinatal stress, such as intrauterine growth restriction (IUGR) and chorioamnionitis, are pathological processes creating an impaired intrauterine environment. These intrauterine factors are associated with the development of proteinuria, hypertension, and chronic kidney disease (CKD) later in life. Initially, this was thought to be secondary to oligonephropathy, subsequent glomerular hypertrophy, and hyperfiltration, leading to glomerulosclerosis, a further decrease in nephron number, and finally CKD. Nowadays, there is increasing evidence that prematurity and perinatal stress affect not only nephron endowment but also the maturation of podocytes and vasculogenesis. IUGR is associated with podocyte damage and an aggravated course of nephrotic syndrome. Moreover, preterm birth and IUGR are known to cause upregulation of the postnatal renin-angiotensin system, resulting in hypertension. Chorioamnionitis causes damage to the glomeruli, thereby predisposing to the development of glomerulosclerosis. This review aims to summarize current knowledge on the influence of prematurity, IUGR, and chorioamnionitis on the development of different glomerular structures. After summarizing human and experimental data on low nephron number in general, a specific focus on the current understanding of podocyte and glomerular capillary formation in relation to prematurity and different causes of perinatal stress is presented.
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Affiliation(s)
- Lieke A. Hoogenboom
- grid.412966.e0000 0004 0480 1382Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands ,grid.461578.9Department of Pediatric Nephrology, Radboudumc Amalia Children’s Hospital, Nijmegen, The Netherlands
| | - Tim G. A. M. Wolfs
- grid.412966.e0000 0004 0480 1382Department of Pediatrics, Maastricht University Medical Centre+, Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Pediatrics, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Biomedical Engineering (BMT), Maastricht University, Maastricht, The Netherlands
| | - Matthias C. Hütten
- grid.5012.60000 0001 0481 6099Department of Pediatrics, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands ,grid.412966.e0000 0004 0480 1382Department of Neonatology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Carine J. Peutz-Kootstra
- grid.412966.e0000 0004 0480 1382Department of Pathology, School for Cardiovascular Diseases (CARIM), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Michiel F. Schreuder
- grid.461578.9Department of Pediatric Nephrology, Radboudumc Amalia Children’s Hospital, Nijmegen, The Netherlands
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Sasaki T, Tsuboi N, Marumoto H, Okabayashi Y, Haruhara K, Kanzaki G, Koike K, Ogura M, Ninomiya T, Yokoo T. Nephron Number and Time to Remission in Steroid-Sensitive Minimal Change Disease. Kidney Med 2020; 2:559-568.e1. [PMID: 33094274 PMCID: PMC7568083 DOI: 10.1016/j.xkme.2020.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Harer MW, Charlton JR, Tipple TE, Reidy KJ. Preterm birth and neonatal acute kidney injury: implications on adolescent and adult outcomes. J Perinatol 2020; 40:1286-1295. [PMID: 32277164 DOI: 10.1038/s41372-020-0656-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/02/2020] [Accepted: 03/11/2020] [Indexed: 02/06/2023]
Abstract
As a result of preterm birth, immature kidneys are exposed to interventions in the NICU that promote survival, but are nephrotoxic. Furthermore, the duration of renal development may be truncated in these vulnerable neonates. Immaturity and nephrotoxic exposures predispose preterm newborns to acute kidney injury (AKI), particularly in the low birth weight and extremely preterm gestational age groups. Several studies have associated preterm birth as a risk factor for future chronic kidney disease (CKD). However, only a few publications have investigated the impact of neonatal AKI on CKD development. Here, we will review the evidence linking preterm birth and AKI in the NICU to CKD and highlight the knowledge gaps and opportunities for future research. For neonatal intensive care studies, we propose the inclusion of AKI as an important short-term morbidity outcome and CKD findings such as a reduced glomerular filtration rate in the assessment of long-term outcomes.
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Affiliation(s)
- Matthew W Harer
- Department of Pediatrics, Division of Neonatology, University of Wisconsin-Madison, Madison, WI, USA
| | - Jennifer R Charlton
- Department of Pediatrics, Division of Nephrology, University of Virginia Children's Hospital, Box 800386, Charlottesville, VA, USA.
| | - Trent E Tipple
- Department of Pediatrics, Section of Neonatal-Perinatal Medicine, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
| | - Kimberly J Reidy
- Department of Pediatrics, Division of Pediatric Nephrology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
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