Skip to main content
SpringerLink
Log in

Renal volume and function in school-age children born preterm or small for gestational age

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Impaired renal development during foetal life is a proposed mechanism for adult hypertension in people born small. Whether preterm birth contributes to such adverse development is still unclear. We investigated the selective contributions from foetal growth restriction or preterm birth to renal function and volume in children with low birth weight. Three groups of 9 to 12-year-old children were studied: those born at < 32 gestational weeks (preterm, n = 39), those born at term but small for gestational age (SGA, n = 29) and those born at the term appropriate for gestational age (controls, n = 37). We estimated renal function by calculating glomerular filtration rate (GFR) and by measuring urinary proteins. Volumetric ultrasound of the kidneys was performed in 86 children (preterm, n = 33; SGA, n = 25; controls, n = 29). Estimated glomerular filtration rate (eGFR) and urinary protein patterns were similar between the groups. Kidney volume (preterm 162 ml (31); SGA 163 ml (26) and controls 182 ml (47)) was smaller in the preterm group than in the controls, but the difference was not significant when adjusted for body surface area, gender and age (P = 0.25). Total renal volume correlated to birth weight (r = 0.23, P = 0.03). No significant differences were found in renal function or volume between the three groups at school age.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barker DJ, Osmond C, Golding J, Kuth PD, Wadsworth MEJ (1989) Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ 298:564–567

    Article  CAS  Google Scholar 

  2. Brenner BM, Garcia DL, Anderson S (1988) Glomeruli and blood pressure: Less of one, more the other? Am J Hypertens 1:335–347

    Article  CAS  Google Scholar 

  3. Brenner BM, Chertow GM (1994) Congenital oligonephropathy and the etiology of adult hypertension and progressive renal injury. Am J Kidney Dis 23:171–175

    Article  CAS  Google Scholar 

  4. Hinchlife SA, Lynch MR, Sargent PH, Howard CV, Van Velzen D (1992) The effect of intrauterine growth retardation on the development of renal nephrons. Br J Obstet Gynaecol 99:296–301

    Article  Google Scholar 

  5. Manalich R, Reyes L, Herrera M, Melendi C, Fundora I (2000) Relationship between weight at birth and the number and size of renal glomeruli in humans: a histomorphometric study. Kidney Int 58:770–773

    Article  CAS  Google Scholar 

  6. Merlet-Benichou C, Gilbert T, Muffat-Joly M, Lelievre-Pegorier M, Leroy B (1994) Intrauterine growth retardation leads to a permanent nephron deficit in the rat. Pediatr Nephrol 8:175–180

    Article  CAS  Google Scholar 

  7. Hughson MD, Douglas-Denton R, Bertram JF, How WE (2006) Hypertension, glomerular number, and birth weight in African Americans and white subjects in the southeastern United States. Kidney Int 69:671–678

    Article  CAS  Google Scholar 

  8. Silver LE, Decamps PJ, Korst LM, Platt LD, Castro LC (2003) Intrauterine growth restriction is accompanied by decreased renal volume in the human fetus. Am J Obstet Gynecol 188:1320–1325

    Article  Google Scholar 

  9. Fan ZJ, Lackland DT, Lipsitz SR, Nicholas JS (2006) The association of low birth weight and chronic renal failure among Medicaid young adults with diabetes and/or hypertension. Public Health Rep 121:239–244

    Article  Google Scholar 

  10. Hoy WE, Rees M, Kile E, Mathews JD, McCredie DA, Pugsley DJ, Wang Z (1998) Low birth weight and renal disease in Australian aborigines. Lancet 352:1826–1827

    Article  CAS  Google Scholar 

  11. Vanpée M, Blennow M, Linné T, Herin P, Apeira A (1992) Renal function in very low birth weight infants: normal maturity reached during early childhood. J Pediatr 121:784–788

    Article  Google Scholar 

  12. Johansson S, Norman M, Legnevall L, Dalmaz Y, Lagercrantz H, Vanpée M (2007) Increased catecholamines and heart rate in children with low birth weight: perinatal contributions to sympathoadrenal overactivity. J Intern Med 261:480–487

    Article  CAS  Google Scholar 

  13. Edstedt Bonamy AK, Bendito A, Martin H, Andolf E, Sedin G, Norman M (2005) Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res 58:845–849

    Article  Google Scholar 

  14. Kistner A, Celsi G, Vanpée M, Jacobson SH (2000) Renal function and blood pressure control in adult women born preterm or small for gestational age. Pediatr Nephrol 15:215–220

    Article  CAS  Google Scholar 

  15. Johansson S, Iliadou A, Bergvall N, Tuvemo T, Norman M, Cnattingius S (2005) Risk of high blood pressure among young men increases with the degree of immaturity at birth. Circulation 112:3430–3436

    Article  Google Scholar 

  16. Høgberg U (1997) Early dating by ultrasound and perinatal outcome. A cohort study. Acta Obstet Gynecol Scand 76:907–912

    Article  Google Scholar 

  17. Marsal K, Persson PH, Larsen T, Lilja H, Selbing A, Sultan B (1996) Intrauterine growth curves based on ultrasonically estimated foetal weights. Acta Paediatr 85:843–848

    Article  CAS  Google Scholar 

  18. Morris SS, Victoria CG, Barros FC, Halpern R, Menezes, AMB, César JA, Horta BL, Tomasi E (1998) Length and ponderal index at birth: associations with mortality, hospitalizations, development and post-natal growth in Brazilian infants. Int J Epidemiol 27:242–247

    Article  CAS  Google Scholar 

  19. Roberts JM, Pearson G, Cutler J, Lindheimer M (2003) Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension 41:437–445

    Article  CAS  Google Scholar 

  20. Schwartz GJ, Haycock GB, Edelman CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263

    CAS  Google Scholar 

  21. Park MK, Menard SM (1987) Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 79:907–914

    CAS  PubMed  Google Scholar 

  22. Dinkel E, Ertel M, Dittrich M, Peters H, Berres M, Schulte Wissermann H (1985) Kidney size in childhood. Sonographical growth charts for kidney length and volume. Pediatr Radiol 15:38–43

    Article  CAS  Google Scholar 

  23. Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height weight formula validated in infants, children and adults. J Pediatr 93:62–66

    Article  CAS  Google Scholar 

  24. Lane PH, Belsha CW, Plummer J, Steinhardt GF, Lynch RE, Wood EG (1998) Relationship of renal size, body size, and blood pressure in children. Pediatr Nephrol 12:35–39

    Article  CAS  Google Scholar 

  25. Srivastava T (2006) Nondiabetic consequences of obesity on kidney. Pediatr Nephrol 21:463–470

    Article  Google Scholar 

  26. Saran AM, Hsu FC, Lohman KK, Carr JJ, Bowden DW, Wagenknecht LE, Freedman BI (2008) Kidney volume associations with subclinical renal and cardiovascular disease: the diabetes heart study. Am J Nephrol 28:366–371

    Article  Google Scholar 

  27. Schmidt IM, Chellakooty M, Boisen KA, Damgaard IN, Mau KC, Olgaard K, Main KM (2005) Impaired kidney growth in low-birth-weight children: distinct effects of maturity and weight for gestational age. Kidney Int 68:731–740

    Article  Google Scholar 

  28. Keijzer-Veen MG, Schrevel M, Finken MJ, Dekker FW, Nauta J, Hille ET, Frolich M, van der Heijden BJ (2005) Dutch POPS-19 Collaborative Study Group. Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 9:2762–2768

    Article  Google Scholar 

  29. Rodríguez-Soriano J, Aguirre M, Oliveros R, Vallo A (2005) Long-term renal follow-up of extremely low birth weight infants. Pediatr Nephrol 20:579–584

    Article  Google Scholar 

  30. Nyengaard JR, Bendtsen TF (1992) Glomerular number and size in relation to age, kidney weight and body surface in normal man. Anat Rec 232:194–201

    Article  CAS  Google Scholar 

  31. Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25

    Article  Google Scholar 

  32. Rodríguez MM, Gómez A, Abitbol C, Chandar J, Montané B, Zilleruelo G (2005) Comparative renal histomorphometry: a case study of oligonephropathy of prematurity. Pediatr Nephrol 20:945–949

    Article  Google Scholar 

  33. Cuzzolin L, Fanos V, Pinna B, di Marzio M, Perin M, Tramontozzi P, Tonetto P, Cataldi L (2006) Postnatal renal function in the preterm newborns: a role of diseases, drugs and therapeutic interventions. Pediatr Nephrol 21:931–938

    Article  Google Scholar 

Download references

Acknowledgements

The study was funded by the May Flower Annual Campaign for Children’s Health, the Swedish Medical Association, Sällskapet Barnavård, Mjölkdroppen Foundation, Freemason Children’s Foundation in Stockholm, and the Swedish Heart and Lung Foundation. We sincerely thank the participating children and their families for making this study possible.

Author information

Authors and Affiliations

  1. Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden

    Alexander Rakow, Stefan Johansson, Lena Legnevall, Robin Sevastik, Gianni Celsi, Mikael Norman & Mireille Vanpée

  2. Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    Gianni Celsi & Mikael Norman

  3. Karolinska University Hospital-Danderyd, 182 88, Stockholm, Sweden

    Alexander Rakow

Authors
  1. Alexander Rakow
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefan Johansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lena Legnevall
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robin Sevastik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gianni Celsi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mikael Norman
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mireille Vanpée
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alexander Rakow.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rakow, A., Johansson, S., Legnevall, L. et al. Renal volume and function in school-age children born preterm or small for gestational age. Pediatr Nephrol 23, 1309–1315 (2008). https://doi.org/10.1007/s00467-008-0824-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-008-0824-z

Keywords

Search

Navigation