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Glomerular Filtration Rate in Former Extreme Low Birth Weight Infants over the Full Pediatric Age Range: A Pooled

Elise Goetschalckx1, Djalila Mekahli1,2, Elena Levtchenko1,2

  • 1Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.

International Journal of Environmental Research and Public Health
|March 28, 2020
PubMed

Insights

Former extremely low birth weight (ELBW) neonates show reduced glomerular filtration rate (GFR) throughout childhood. This pooled analysis confirms a consistent pattern of impaired kidney function in ELBW survivors compared to term-born peers.

Area of Science:

  • Pediatric Nephrology
  • Neonatal Medicine
  • Public Health

Background:

  • Extremely low birth weight (ELBW) neonates (<1000 g) are at risk for long-term health issues.
  • Previous studies indicate lower glomerular filtration rate (GFR) in ELBW survivors during childhood.
  • A comprehensive understanding of GFR patterns in this population is needed.

Purpose of the Study:

  • To systematically review and pool data from existing cohort studies.
  • To describe the glomerular filtration rate (GFR) pattern in former ELBW neonates across the pediatric age range.
  • To compare GFR in ELBW survivors with healthy, age-matched controls.

Main Methods:

  • Systematic review of studies reporting GFR measurements in former ELBW cases and controls.
  • Inclusion of 6 case-control and 3 cohort studies with 444 GFR measurements in 380 former ELBW cases (median age 5.3-20.7 years).
  • Analysis of GFR data using various measurement tools (inulin, cystatin C, creatinine-estimated GFR formulae).

Main Results:

  • Former ELBW individuals consistently exhibited a lower median GFR (-13%, range -8% to -25%) compared to controls.
  • A significant minority (15-30%) of ELBW survivors had an estimated GFR (eGFR) below 90 mL/min/1.73 m2.
  • A consistent pattern of reduced eGFR was observed in former ELBW cases throughout childhood.

Conclusions:

  • This pooled analysis confirms a consistent pattern of reduced eGFR in former ELBW survivors throughout childhood.
  • Impaired kidney function is a significant long-term outcome for ELBW individuals.
  • Future research should address perinatal risk factors and long-term outcomes, acknowledging limitations in current data (single-center studies, small cohorts, GFR assessment heterogeneity).

Keywords:
Brenner hypothesisextreme low birth weight infantsglomerular filtration raterenal outcome

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