Alexandra Bruel1,2, Jean-Christophe Rozé3,4, Marie-Pierre Quere5, Cyril Flamant3,4, Marion Boivin4, Gwenaëlle Roussey-Kesler6,4, Emma Allain-Launay6,4. 1. Department of Pediatrics, Nantes University Hospital, Nantes, France. alexandra.bruel@chu-nantes.fr. 2. CIC 004, INSERM-Nantes University Hospital, Nantes, France. alexandra.bruel@chu-nantes.fr. 3. Neonatal Intensive Care Unit, Nantes University Hospital, Nantes, France. 4. CIC 004, INSERM-Nantes University Hospital, Nantes, France. 5. Department of Pediatric Radiology, Nantes University Hospital, Nantes, France. 6. Department of Pediatrics, Nantes University Hospital, Nantes, France.
Abstract
OBJECTIVES: Acute kidney injury (AKI) is a severe complication of prematurity, with currently unknown consequences for renal function in childhood. The objective of this study was to search for signs of reduced nephron number in children aged 3-10 years who had been born preterm with neonatal AKI and compare this group to control children. METHODS: IRENEO was a prospective, controlled study conducted in 2013 in Nantes University Hospital. Children who were born at less than 33 weeks gestational age (GA) and included in the LIFT cohort were eligible for entry. Twenty-five children with AKI (AKI-C) and 49 no-AKI children were matched on a propensity score of neonatal AKI and age. AKI was defined as a serum creatinine level higher than critical values: 1.6 mg/dl (GA 24-27 weeks), 1.1 mg/dl (28-29) and 1 mg/dl (GA 30-32). Renal function was evaluated during childhood. RESULTS: Mean age of the children at the time of the study was 6.6 years. No difference in microalbuminuria, estimated glomerular filtration rate (GFR) or pulse wave velocity was observed between the two groups. Renal volume was lower in the AKI-C group (57 vs. 68; p = 0.04). In the entire cohort, 10.8 % had a microalbuminuria, and 23 % had a diminished GFR (median 79 ml/min/1.73 m2). The GFR was lower in children with very low birth weight of <1000 g (99 vs. 107 ml/min/1.73 m2; p = 0.04). CONCLUSION: In children born preterm, neonatal AKI does not seem to influence renal function. However, independent ofAKI, a large proportion of very preterm infants, especially those with very low birth weight, presented with signs of nephron reduction, thus requiring follow-up with a nephrologist.
OBJECTIVES:Acute kidney injury (AKI) is a severe complication of prematurity, with currently unknown consequences for renal function in childhood. The objective of this study was to search for signs of reduced nephron number in children aged 3-10 years who had been born preterm with neonatal AKI and compare this group to control children. METHODS: IRENEO was a prospective, controlled study conducted in 2013 in Nantes University Hospital. Children who were born at less than 33 weeks gestational age (GA) and included in the LIFT cohort were eligible for entry. Twenty-five children with AKI (AKI-C) and 49 no-AKI children were matched on a propensity score of neonatal AKI and age. AKI was defined as a serum creatinine level higher than critical values: 1.6 mg/dl (GA 24-27 weeks), 1.1 mg/dl (28-29) and 1 mg/dl (GA 30-32). Renal function was evaluated during childhood. RESULTS: Mean age of the children at the time of the study was 6.6 years. No difference in microalbuminuria, estimated glomerular filtration rate (GFR) or pulse wave velocity was observed between the two groups. Renal volume was lower in the AKI-C group (57 vs. 68; p = 0.04). In the entire cohort, 10.8 % had a microalbuminuria, and 23 % had a diminished GFR (median 79 ml/min/1.73 m2). The GFR was lower in children with very low birth weight of <1000 g (99 vs. 107 ml/min/1.73 m2; p = 0.04). CONCLUSION: In children born preterm, neonatal AKI does not seem to influence renal function. However, independent ofAKI, a large proportion of very preterm infants, especially those with very low birth weight, presented with signs of nephron reduction, thus requiring follow-up with a nephrologist.
Authors: Maria M Rodríguez; Alexander H Gómez; Carolyn L Abitbol; Jayanthi J Chandar; Shahnaz Duara; Gastón E Zilleruelo Journal: Pediatr Dev Pathol Date: 2004 Jan-Feb
Authors: Mandy G Keijzer-Veen; Martijn J J Finken; Jeroen Nauta; Friedo W Dekker; Elysée T M Hille; Marijke Frölich; Jan M Wit; A J van der Heijden Journal: Pediatrics Date: 2005-09 Impact factor: 7.124
Authors: Michael G Shlipak; Kunihiro Matsushita; Johan Ärnlöv; Lesley A Inker; Ronit Katz; Kevan R Polkinghorne; Dietrich Rothenbacher; Mark J Sarnak; Brad C Astor; Josef Coresh; Andrew S Levey; Ron T Gansevoort Journal: N Engl J Med Date: 2013-09-05 Impact factor: 91.245
Authors: Mandy G Keijzer-Veen; Hilda A Kleinveld; Maarten H Lequin; Friedo W Dekker; Jeroen Nauta; Yolanda B de Rijke; Bert J van der Heijden Journal: Am J Kidney Dis Date: 2007-10 Impact factor: 8.860
Authors: Cory N Criss; David T Selewski; Bipin Sunkara; Joshua S Gish; Lily Hsieh; Jennifer S Mcleod; Jason O Robertson; Niki Matusko; Samir K Gadepalli Journal: Pediatr Nephrol Date: 2017-10-05 Impact factor: 3.714
Authors: Valerie A Luyckx; Norberto Perico; Marco Somaschini; Dario Manfellotto; Herbert Valensise; Irene Cetin; Umberto Simeoni; Karel Allegaert; Bjorn Egil Vikse; Eric A Steegers; Dwomoa Adu; Giovanni Montini; Giuseppe Remuzzi; Barry M Brenner Journal: Lancet Date: 2017-03-09 Impact factor: 79.321