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Updated: Jan 19, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Long-term renal follow up of preterm neonates born before 35 weeks of gestation
Akiyoshi Horie1, Yasuhiro Abe1, Daisuke Koike1
1Division of Pediatrics, Shimane Prefectural Central Hospital, Himebara, Izumo, Shimane, Japan.
Insights
Premature birth and low birthweight impact children's kidney function. High serum creatinine levels in the first week of life indicate a risk for chronic kidney disease, necessitating early monitoring.
Area of Science:
- Pediatrics
- Nephrology
- Developmental Biology
Background:
- The Developmental Origins of Health and Disease hypothesis links early-life factors to adult chronic diseases.
- Few studies confirm these early-life impacts on renal function in childhood.
- This study investigates the effects of premature birth and low birthweight on Japanese children's renal function.
Purpose of the Study:
- To assess the impact of premature birth and low birthweight on renal function in Japanese children.
- To identify early indicators of potential renal dysfunction in high-risk infants.
Main Methods:
- Retrospective study of 168 infants born before 35 weeks gestation.
- Follow-up duration exceeding 2 years.
- Analysis of serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) from medical records.
Main Results:
- eGFR at 2 years correlated significantly with birthweight and gestational age (P < 0.01).
- 10.7% of children exhibited low eGFR (<90 mL/min/1.73 m²) without clinical symptoms.
- High initial sCr on day 7 and delayed recovery were linked to low eGFR.
Conclusions:
- Premature gestational age and low birthweight directly impact early childhood renal function.
- Elevated day 7 sCr is a risk factor for developing chronic kidney disease in children.
- Close renal function monitoring is crucial for premature and low-birthweight infants from early childhood.
Background:
The hypothesis of the Developmental Origins of Health and Disease states that environmental factors during fetal and infantile life are risk factors for some chronic diseases in adulthood. Few studies, however, have confirmed this hypothesis early in childhood. Therefore, we assessed how premature birth and low-birthweight (LBW) affect the renal function of Japanese children.
Methods:
This retrospective study surveyed 168 patients who were born before 35 weeks of gestation and were cared for at the present neonatal intensive care unit. Follow-up duration was >2 years. Serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) recorded in medical records were reviewed.
Results:
The eGFR at 2 years of age was significantly correlated with birthweight and gestational age (P < 0.01). Approximately 10.7% of the children had low eGFR (<90 mL/min/1.73 m2 ) without clinical symptoms or abnormal urine examination. These children had high sCr on day 7 after birth (P < 0.01) and delayed recovery of these levels during the first month after birth.
Conclusion:
Premature gestational age and LBW directly affect renal function in young children. High sCr on day 7 after birth is a risk factor for chronic kidney disease in children. Careful follow up of renal function is therefore required for premature infants and infants with LBW beginning in early childhood to prevent renal dysfunction.
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