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The Link Between Preterm Birth and Long-Term Renal Consequences: Current Knowledge and Emerging Therapeutic Targets
John Dotis1, Alexandra Skarlatou2, Maria Fourikou1
1Third Department of Pediatrics, Aristotle University of Thessaloniki, Hippokration Hospital, 54642 Thessaloniki, Greece.
Biomedicines
|March 28, 2026
Summary
Preterm birth significantly increases the risk of chronic kidney disease (CKD) due to reduced nephron endowment and postnatal factors. Long-term monitoring and early interventions are crucial for kidney health in preterm infants.
Area of Science:
- Nephrology
- Developmental Biology
- Public Health
Background:
- Preterm birth disrupts kidney development, leading to fewer nephrons and lifelong renal vulnerability.
- Individuals born preterm face elevated risks of hypertension, albuminuria, and chronic kidney disease (CKD).
Purpose of the Study:
- Synthesize evidence on prematurity and adverse renal outcomes.
- Explore underlying pathophysiological mechanisms.
- Discuss emerging biomarkers and therapeutic strategies for nephroprotection.
Main Methods:
- Comprehensive review of clinical cohort studies, registries, meta-analyses, and experimental models.
- Integration of factors like neonatal acute kidney injury (AKI), nephrotoxic exposures, and cardiometabolic interactions.
- Life-course perspective adopted to analyze renal health trajectories.
Main Results:
- Reduced nephron endowment, glomerular hypertrophy, and hyperfiltration predispose to progressive kidney damage.
- Postnatal factors (AKI, inflammation, nephrotoxins, cardiometabolic stress) accelerate renal injury.
- Higher prevalence of reduced GFR, albuminuria, hypertension, and smaller kidney volumes observed in preterm individuals.
Conclusions:
- Preterm birth is an independent, lifelong risk factor for CKD via developmental and postnatal pathways.
- Structured long-term surveillance and early preventive strategies are vital for preserving renal reserve.
- Biomarker-guided monitoring and targeted interventions can enable early risk identification and precision nephroprotection.
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