Prenatal programming of renal function: the estimated glomerular filtration rate is influenced by size at birth in apparently healthy children.

Prenatal growth is known to affect glomerular function in adult life. It is unknown, however, whether this association is also present in children. In a cross-sectional study, we examined whether birth weight (BW) is associated with serum creatinine (measured by an improved Jaffe method) and GFR (estimated by the Haycock-Schwartz formula; eGFR) in 73 apparently healthy school-age children (35 boys and 38 girls; age 9.5 +/- 0.4 yr). All children were born after singleton term pregnancies (gestational age 39.6 +/- 0.2 wk) with normal BW (3.2 +/- 0.04 kg). A significant decrease in serum creatinine and increase in the eGFR was evident by tertiles of BW-SD score (SDS) (p = 0.001 and p < 0.0001). eGFR was correlated with BW-SDS (r = 0.45; p < 0.0001), so that each unit increase in BW-SDS was associated with an increase in eGFR of 10 (95% CI 5-14) ml/min per 1.73 m. In summary, estimates of glomerular function are in apparently healthy school-age children influenced by size at birth. These findings suggest early effects for the prenatal programming of renal function in humans.