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Renal function and systolic blood pressure in very-low-birth-weight infants 1-3 years of age.
MedLine Citation:
PMID:  22832668     Owner:  NLM     Status:  Publisher    
BACKGROUND: Preterm very-low-birth-weight (PT-VLBW) infants are at risk of an elevated systolic blood pressure (SBP) in infancy and adulthood; however, the pathogenesis remains unclear. Altered renal development or function may be associated with increased SBP, but their contribution in PT-VLBW is unknown. METHODS: We determined renal function and its relationship to SBP in three groups of PT-VLBW at 1, 2, and 3 years of age, using serum cystatin-C to calculate the estimated glomerular filtration rate (eGFR). RESULTS: Cystatin-C levels decreased from 0.84 ± 0.2 (SD) within the 1-year group to 0.70 ± 0.1 mg/l (±SD; P < 0.001) at 3 years and were unrelated to gender, fetal growth, and neonatal indomethacin exposure. eGFR rose from 121 ± 59 in the 1-year group to 138 ± 21 ml/min·1.73 m(2) (P < 0.001) at 3 years. At 1 year, cystatin-C levels decreased with increasing SBP (P < 0.007), and infants with SBP ≥ 90th% had lower cystatin-C and higher eGFR (P < 0.05). At 3 years, infants with lower birth weight (P < 0.03) and gestational age (P = 0.06) had reduced eGFR. CONCLUSIONS: Preterm very-low-birth-weight infants demonstrate increasing renal function with advancing age. An elevated SBP and eGFR at 1 year suggests dysfunctional renal autoregulation and hyperfiltration, which may alter subsequent renal function and contribute to the lower eGFR seen at 3 years in infants with the lowest birth weight and gestational age.
Joshua A Frankfurt; Andrea F Duncan; Roy J Heyne; Charles R Rosenfeld
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-26
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  -     ISSN:  1432-198X     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical School at Dallas, 5323 Harry Hines Boulevard, Dallas, TX, 75390-9002, USA.
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