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Fetal growth restriction followed by very preterm birth is associated with smaller kidneys but preserved kidney

Jonas Liefke1, Caroline Heijl2, Katarina Steding-Ehrenborg1

  • 1Clinical Physiology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.

Pediatric Nephrology (Berlin, Germany)
|November 21, 2022
PubMed

Insights

Adolescents born very preterm with fetal growth restriction (FGR) have smaller kidney volumes but normal kidney function. These structural changes may predict future kidney disease risk.

Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Fetal Medicine

Background:

  • Preterm birth and fetal growth restriction (FGR) are linked to long-term kidney disease and hypertension risks.
  • Previous studies on preterm children show conflicting results regarding structural kidney changes and function.
  • This study investigates kidney structure and function in adolescents born very preterm, with and without FGR.

Purpose of the Study:

  • To assess kidney structure and function in adolescents born very preterm.
  • To compare kidney parameters in adolescents with and without a history of FGR.
  • To evaluate potential long-term consequences of FGR and preterm birth on renal health.

Main Methods:

  • Magnetic resonance imaging (MRI) was used to measure cortical and medullary kidney volumes and T1/T2* mapping.
  • Biochemical markers of kidney function and renin-angiotensin-aldosterone system (RAAS) activation were analyzed.
  • Adolescents born very preterm with FGR were compared to those born preterm with appropriate for gestational age (AGA) and term-born AGA controls.

Main Results:

  • Adolescents born very preterm with FGR exhibited significantly smaller total and medullary kidney volumes compared to term-born AGA controls.
  • A decreased corticomedullary volume ratio was observed in preterm FGR and preterm AGA groups compared to term AGA.
  • No significant differences were found in kidney function markers (biochemical) or RAAS activation between the groups.

Conclusions:

  • Very preterm birth combined with FGR is associated with reduced total and medullary kidney volumes in adolescence.
  • Despite structural changes, current markers of kidney function and RAAS activation were not different between groups.
  • Diminished kidney volumes may serve as a prognostic marker for future kidney function decline.
Abstract

Keywords:
AdolescenceAngiotensinogenFetal growth restrictionKidney functionKidney parenchymaKidney volumeRenal cortical volumeRenal medullary volumeVery preterm

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