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Retrospective cohort study of individuals born with low birthweight: implications for screening practices
Xixi Zhao1, Andrea K Kratzke2, Fatima Ballout3
1Department of Internal Medicine and Pediatrics, Rush University Medical Center, Chicago, IL, USA.
Insights
Low birthweight (LBW) is linked to lower kidney function in children and young adults. Screening for chronic kidney disease (CKD) in extremely low birthweight (ELBW) individuals is recommended from age 9.
Area of Science:
- Pediatric Nephrology
- Neonatal Research
- Public Health
Background:
- Established association between low birthweight (LBW) and future kidney disease.
- Limited understanding of kidney dysfunction progression from childhood to adulthood in LBW individuals.
Purpose of the Study:
- To investigate the long-term effects of birthweight on kidney disease progression.
- To compare glomerular filtration rate (GFR) trajectories in LBW versus normal birthweight (NBW) individuals.
Main Methods:
- Retrospective cohort study of infants admitted to NICU (1992-2006).
- Comparison of GFR between LBW (<2500g) and NBW infants.
- Follow-up ranged from 1 to 26 years.
Main Results:
- Significantly lower GFR in LBW individuals compared to NBW (mean difference 5.5 mL/min/1.73m²).
- GFR differences were evident in adolescents and young adults (>9 years).
- Extremely low birthweight (ELBW, <1000g) group showed pronounced GFR reduction.
Conclusions:
- Recommend CKD screening for ELBW individuals starting at age 9.
- Screening should be irrespective of prior medical history.
- Early identification of kidney dysfunction in ELBW individuals is crucial.
Background:
Previous studies have established an association between low birthweight (LBW) and future kidney disease, but few have explored the progression of kidney dysfunction through the pediatric years leading up through adolescence and young adulthood.
Methods:
To better understand the temporal effects of birthweight on kidney disease progression, we conducted a retrospective cohort study comparing the glomerular filtration rate (GFR) between LBW (<2500 grams) and normal birthweight (NBW) infants who were admitted to the neonatal intensive care unit (NICU) at our institution from 1992 to 2006.
Results:
Age at follow-up ranged 1-26 years old. GFR was found to be significantly lower in participants born with LBW than those born with NBW, with a mean difference of 5.5 mL/min/1.73m2 (P < 0.01). These differences were found in the adolescent and young adult age group over 9 years of age, specifically in the extremely low birthweight group (ELBW) whose birthweight was less than 1000 grams.
Conclusions:
We recommend screening for CKD in ELBW individuals starting at the age of 9 years old, regardless of their previous medical history.
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