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Renal calcification in preterm infants: follow up at 4-5 years
Insights
Neonatal renal calcification in preterm infants did not significantly impact later renal function. Studies show preterm infants may have underlying renal dysfunction, independent of early calcification.
Area of Science:
- Pediatric Nephrology
- Neonatal Medicine
- Renal Physiology
Background:
- Preterm birth is associated with an increased risk of renal complications.
- Neonatal renal calcification is a recognized condition in preterm infants, but its long-term consequences are not fully understood.
Purpose of the Study:
- To investigate the long-term renal functional outcomes in preterm infants who experienced neonatal renal calcification.
- To assess whether neonatal renal calcification is a significant predictor of subsequent renal dysfunction in this population.
Main Methods:
- A cohort study followed 11 preterm infants with neonatal renal calcification and 17 matched controls up to 4-5 years of age.
- Renal ultrasound, calcium load tests, and desmopressin tests for renal concentrating ability (RCA) were performed.
- Glomerular filtration rate (GFR) and tubular phosphate reabsorption (Tp/GFR) were assessed in the study group.
Main Results:
- No significant differences were observed between the study and control groups in renal size, calciuria, or RCA.
- While five children in the study group still showed ultrasonic evidence of renal calcification, overall renal function parameters did not differ significantly.
- Combined analysis revealed lower-than-published renal concentrating ability (RCA) in both preterm infants and controls, suggesting a broader issue.
Conclusions:
- Preterm infants exhibit evidence of renal dysfunction, irrespective of neonatal renal calcification.
- Neonatal renal calcification appears to be a minor factor in the development of later renal function abnormalities in preterm infants.
Aim:
To determine the consequences of renal calcification in preterm infants.
Methods:
A cohort of 11 preterm babies was studied at the age of 4 to 5 years. They had had renal calcification as neonates. Seventeen matched controls were also studied. Each child had a renal ultrasound scan, a calcium load test, and a desmopressin test for renal concentrating ability (RCA). The study group also had glomerular filtration rate (GFR) estimated, using the height:creatinine ratio, and tubular phosphate reabsorption, without phosphate load, per glomerular filtration rate (Tp/GFR) calculated,
Results:
In the study group the median GFR was 61 ml/min/1.73m2 (range 46-79 ml/min/1.73m2) and the median calculated Tp/GFR SD score was -0.94 (range -2.8-0.68). Five children out of the study group had ultrasonic evidence of renal calcification. There was no significant difference between the two groups in renal size, calciuria, before or after calcium load, or RCA. Eight children (three patients, five controls) had an abnormal calcium load test. The RCA of the children in the study and control groups combined was below that of published values, with a median calculated SD score -0.71 (95% CI -1.21 to -0.23).
Conclusions:
There was evidence of renal dysfunction in children who had been born preterm. Renal calcification detected in the neonatal period does not seem to be a major predisposing factor for the abnormalities of renal function subsequently observed in these infants.