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Increased albuminuria in 4-year-old preterm-born children with normal height
Rachel Vieux1, Jean-Michel Hascoët, Patricia Franck
1Neonatal Department, Nancy, France. r.vieux@maternite.chu-nancy.fr
Insights
Preterm-born children with normal height at age 4 may face higher risks for kidney damage, specifically glomerulosclerosis. This finding highlights the importance of monitoring kidney health in this vulnerable population.
Area of Science:
- Pediatric Nephrology
- Neonatal Medicine
- Public Health
Background:
- Preterm birth is associated with long-term health risks, including potential kidney complications.
- Early identification of risk factors for hypertension and kidney dysfunction in preterm infants is crucial for timely intervention.
Purpose of the Study:
- To investigate risk factors for elevated blood pressure (BP), glomerulosclerosis, and tubular dysfunction in 4-year-old children born preterm.
- To identify predictors of kidney health markers at age 4 in a cohort of preterm-born children.
Main Methods:
- A longitudinal cohort study involving 119 preterm-born children.
- Measurements of BP, albuminuria, and β2 microglobulin were collected during the neonatal period and at 4 years of age.
Main Results:
- 12.6% of 4-year-olds had elevated systolic BP (>95th percentile).
- Children with height <-1 SD had lower BP; however, normal height at age 4 was linked to increased albuminuria.
- Female sex and normal height at age 4 were independently associated with higher albuminuria levels, indicating potential glomerulosclerosis.
Conclusions:
- Normal height at 4 years of age may signal an increased risk for glomerulosclerosis in preterm-born children.
- These findings underscore the need for continued monitoring of renal health in children born preterm, particularly those with normal stature at preschool age.
Objective:
To determine risk factors for high blood pressure (BP), increased markers of glomerulosclerosis, and tubular dysfunction in 4-year-old preterm-born children.
Study Design:
The study group was a longitudinal cohort of 119 children with BP, albuminuria, and β2 microglobulin measurements obtained during the neonatal period and at age 4 years.
Results:
Systolic BP was >95(th) percentile in 15 (12.6%) of the children at age 4 years and lower in those born small for gestational age compared with those born appropriate for gestational age. Preterm-born 4-year-olds with height <-1 SD had lower systolic and diastolic BP, and 14.4% of the 4-year-olds had albuminuria. Albuminuria was less prevalent in the 4-year-olds with height <-1 SD than in those with height ≥-1 SD (6.8% vs 19.3%; P=.04). Mean albuminuria level was 1.0±0.7 mg/mmol in 4-year-olds with height <-1 SD and 1.4±1.3 mg/mmol in those with height ≥-1 SD. In multivariate analysis, albuminuria level was increased by 0.4±0.2 mg/mmol in preterm-born children with normal height at age 4, and by 0.5±0.2 mg/mmol in females, after adjustment for gestational age, sex, neonatal morbidity, and intrauterine growth restriction. These results were unchanged after adjustment for body mass index.
Conclusion:
Normal height at age 4 years may be associated with an increased risk for glomerulosclerosis in preterm-born children.
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