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Childhood kidney outcomes in relation to fetal blood flow and kidney size.
MedLine Citation:
PMID:  24812167     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Impaired fetal abdominal blood flow may lead to smaller kidneys and subsequent impaired kidney function in later life. In a prospective cohort study among 923 pregnant women and their children, we measured fetal growth, kidney volumes, and umbilical and cerebral artery blood flow (median gestational age of 30.3 weeks; 95% range, 28.5-32.7 weeks). We used a higher umbilical/cerebral artery pulsatility index ratio as an indicator of preferential fetal blood flow to the upper body parts at the expense of the intra-abdominal organs. At a median age of 5.9 years (95% range, 5.7-6.6 years), we measured childhood kidney volumes, creatinine and cystatin C blood levels, microalbuminuria, BP, and eGFR. A preferential fetal blood flow to the upper body parts at the expense of the intra-abdominal organs associated only with a smaller combined kidney volume in childhood. Fetal combined kidney volume positively associated with childhood combined kidney volume and eGFR, and inversely associated with childhood creatinine and cystatin C levels (all P values <0.05), but did not associate with childhood microalbuminuria and BP. Children within the highest tertile of fetal umbilical/cerebral ratio and the lowest tertile of fetal combined kidney volume had the lowest eGFR (difference, -6.36 ml/min per 1.73 m(2); 95% confidence interval, -11.78 to -0.94 compared with children within the middle tertiles). These data suggest that impaired fetal blood to the abdominal organs and smaller fetal kidney size are associated with subclinical changes in kidney outcomes in school-aged children.
Authors:
Marjolein N Kooijman; Hanneke Bakker; Albert J van der Heijden; Albert Hofman; Oscar H Franco; Eric A P Steegers; H Rob Taal; Vincent W V Jaddoe
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Publication Detail:
Type:  Journal Article     Date:  2014-05-08
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  25     ISSN:  1533-3450     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-01     Completed Date:  -     Revised Date:  2014-12-06    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2616-24     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 by the American Society of Nephrology.
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