Assessment of long-term renal complications in extremely low birth weight children
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Przemko Kwinta & Ma³gorzata Klimek & Dorota Drozdz & Andrzej Grudzieٌ &Mateusz Jag³a & Magdalena Zasada & Jacek Jozef Pietrzyk
- چاپ و سال / کشور: 2011
Description
We assessed the long-term renal complications in a regional cohort of extremely low birth weight (ELBW) children born in 2002–2004. The study group, comprising 78 children born as ELBW infants (88% of the available cohort), was evaluated with measurement of serum cystatin C, urinary albumin excretion, renal ultrasound, and 24- h ambulatory blood pressure measurements. The control group included 38 children born full-term selected from one general practice in the district. Study patients were evaluated at a mean age of 6.7 years, and had a median birthweight of 890 g (25th–75th percentile: 760–950 g) and a median gestational age of 27 weeks (25th–75th percentile: 26– 29 weeks). Mean serum cystatin C levels were significantly higher (0.64 vs. 0.59 mg/l; p=0.01) in the ELBW group. Hypertension was diagnosed in 8/78 ELBW and 2/38 of the control children (p=0.5). Microalbuminuria (>20 mg/g of creatinine) was detected only in five ELBW children (p=0.17). The mean renal volume was significantly lower in the ELBW group (absolute kidney volume 81 ml vs. 113 ml; p<0.001, relative kidney volume 85 vs. 97%; p<0.001). Abnormally small kidneys (<2/3 of predicted size) were detected in 19 ELBW and four control children (p=0.08). Multivariate logistic regression revealed that the only independent risk factor for renal complications was weight gained during neonatal hospitalization (odds ratio: 0.67; 95% confidence interval: 0.39–0.94). Serum cystatin C and kidney volume are significantly lower in school-age ELBW children. It is important to include systematic renal evaluation in the follow-up programs of ELBW infants.
Pediatr Nephrol (2011) 26:1095–1103 DOI 10.1007/s00467-011-1840-y Received: 7 December 2010 / Revised: 20 February 2011 / Accepted: 24 February 2011 / Published online: 3 April 2011
