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Published on: January 12, 2024
Renal volume of five-year-old preterm children are not different than full-term controls
Jaime M Restrepo1, Laura Torres-Canchala2, Juan Carlos Arias Cadavid3
1Pediatric Nephrology Service, Fundación Valle del Lili, Cali, Colombia.
Insights
Premature infants’ kidney size is similar to healthy children when adjusted for body size. This study found corrected renal volumes and lengths were comparable between groups at age 5, highlighting the importance of body surface area normalization.
Area of Science:
- Pediatric Nephrology
- Neonatology
- Medical Imaging
Background:
- Previous studies indicated smaller renal volumes in premature infants but lacked body surface area correction.
- Renal cortex growth is rapid post-premature birth, necessitating size adjustments for accurate comparisons.
Purpose of the Study:
- To investigate if renal volumes in 5-year-old children born prematurely differ from healthy controls after correcting for body surface area.
- To test the hypothesis that normalized renal volumes would be comparable between groups.
Main Methods:
- An ambispective cohort study included prematurely born infants and a healthy control group.
- Renal length and volume were assessed at age 5 using ultrasonography, with anthropometry and renal function tests.
- Age-independent z-scores were calculated for renal parameters and compared between groups.
Main Results:
- Eighty-nine premature infants (median 32 weeks gestational age) and 33 controls were studied.
- Premature infants had lower weight and body surface area but comparable age, sex, height, blood pressure, and renal function.
- After body surface area correction, renal volume and length z-scores were identical for both kidneys between premature and control groups.
Conclusions:
- Renal volume measurements require correction for body surface area for accurate interpretation.
- Normalized renal volumes and lengths are comparable between 5-year-old children born prematurely and healthy controls.
Objective:
In previous studies, smaller renal volumes were reported in prematurely born infants, however, these renal volumes were not corrected for body surface area, the main determinant of renal size. Given the rapid growth of the renal cortex after premature birth, the authors hypothesized that corrected volumes would not differ from healthy controls.
Methods:
Ambispective cohort study with prospective follow-up of prematurely born babies in a large specialized center and retrospectively recruited healthy control group. Children were assessed for renal length and renal volumes at age 5 by three independent ultrasonographers. Detailed anthropometry, blood pressure and renal function were also obtained. Age independent z-scores were calculated for all parameters and compared using descriptive statistics.
Results:
Eighty-nine premature study participants (median 32 weeks gestational age) and 33 healthy controls (median 38 weeks gestational age) were studied. Study participants did not differ in age, sex, Afro-Colombian descent, height, blood pressure, serum creatinine, or new Schwartz eGFR. Premature study participants had a significantly lower weight (17.65 ± 2.93 kg) than controls (19.05 ± 2.81 kg, p = 0.0072) and lower body surface area. The right renal volumes were significantly smaller (39.4 vs 43.4 mL), but after correction for body surface area, the renal volume and renal length z-scores were identical for both kidneys (mean right kidney -0.707 vs -0.507; mean left kidney -0.498 vs -0.524, respectively).
Conclusion:
Renal volumes need to be corrected to body surface area. After correction for body surface area, 5-year-old healthy and prematurely born children have comparable renal volumes.
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