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Published on: May 22, 2019
Prenatal programming of renal function: the estimated glomerular filtration rate is influenced by size at birth in
Abel López-Bermejo1, Carmen Sitjar, Alicia Cabacas
1Department of Pediatric Endocrinology, Dr. Josep Trueta Hospital, Girona 17007, Spain. uden.alopez@htrueta.scs.es
Insights
Birth weight impacts kidney function in children. Higher birth weight is linked to better estimated glomerular filtration rate (eGFR) in healthy school-age children, suggesting prenatal programming of renal health.
Area of Science:
- Pediatric Nephrology
- Developmental Biology
- Public Health
Background:
- Prenatal growth is recognized to influence adult glomerular function.
- The association between prenatal growth and renal function in childhood remains under-investigated.
Purpose of the Study:
- To investigate the relationship between birth weight and markers of glomerular function in apparently healthy school-age children.
- To determine if prenatal size influences kidney function during childhood.
Main Methods:
- Cross-sectional study of 73 healthy school-age children (9.5 ± 0.4 years).
- Measured serum creatinine using an improved Jaffe method.
- Estimated glomerular filtration rate (eGFR) using the Haycock-Schwartz formula.
- Analyzed association with birth weight standard deviation score (BW-SDS).
Main Results:
- Significant inverse correlation between serum creatinine and BW-SDS (p=0.001).
- Significant positive correlation between eGFR and BW-SDS (p<0.0001).
- Each unit increase in BW-SDS correlated with a 10 ml/min/1.73 m² increase in eGFR (95% CI 5-14).
Conclusions:
- Glomerular function estimates in school-age children are influenced by birth size.
- Findings suggest prenatal programming impacts renal function early in human life.
- Birth weight is a significant factor in childhood kidney function development.
Abstract:
Prenatal growth is known to affect glomerular function in adult life. It is unknown, however, whether this association is also present in children. In a cross-sectional study, we examined whether birth weight (BW) is associated with serum creatinine (measured by an improved Jaffe method) and GFR (estimated by the Haycock-Schwartz formula; eGFR) in 73 apparently healthy school-age children (35 boys and 38 girls; age 9.5 +/- 0.4 yr). All children were born after singleton term pregnancies (gestational age 39.6 +/- 0.2 wk) with normal BW (3.2 +/- 0.04 kg). A significant decrease in serum creatinine and increase in the eGFR was evident by tertiles of BW-SD score (SDS) (p = 0.001 and p < 0.0001). eGFR was correlated with BW-SDS (r = 0.45; p < 0.0001), so that each unit increase in BW-SDS was associated with an increase in eGFR of 10 (95% CI 5-14) ml/min per 1.73 m. In summary, estimates of glomerular function are in apparently healthy school-age children influenced by size at birth. These findings suggest early effects for the prenatal programming of renal function in humans.
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