Fetal growth restriction followed by very preterm birth is associated with smaller kidneys but preserved kidney function in adolescence
(2023) In Pediatric Nephrology 38(6). p.1855-1866- Abstract
- Background: Preterm birth and fetal growth restriction (FGR) are associated with structural and functional kidney changes, increasing long-term risk for chronic kidney disease and hypertension. However, recent studies in preterm children are conflicting, indicating structural changes but normal kidney function. This study therefore assessed kidney structure and function in a cohort of adolescents born very preterm with and without verified FGR.
Methods: Adolescents born very preterm with FGR and two groups with appropriate birthweight (AGA) were included; one matched for gestational week at birth and one born at term. Cortical and medullary kidney volumes and T1 and T2* mapping values were assessed by magnetic resonance imaging.... (More) - Background: Preterm birth and fetal growth restriction (FGR) are associated with structural and functional kidney changes, increasing long-term risk for chronic kidney disease and hypertension. However, recent studies in preterm children are conflicting, indicating structural changes but normal kidney function. This study therefore assessed kidney structure and function in a cohort of adolescents born very preterm with and without verified FGR.
Methods: Adolescents born very preterm with FGR and two groups with appropriate birthweight (AGA) were included; one matched for gestational week at birth and one born at term. Cortical and medullary kidney volumes and T1 and T2* mapping values were assessed by magnetic resonance imaging. Biochemical markers of kidney function and renin-angiotensin-aldosterone system (RAAS) activation were analyzed.
Results: Sixty-four adolescents were included (13-16 years; 48% girls). Very preterm birth with FGR showed smaller total (66 vs. 75 ml/m2; p = 0.01) and medullary volume (19 vs. 24 ml/m2; p < 0.0001) compared to term AGA. Corticomedullary volume ratio decreased from preterm FGR (2.4) to preterm AGA (2.2) to term AGA (1.9; p = 0.004). There were no differences in T1 or T2* values (all p ≥ 0.34) or in biochemical markers (all p ≥ 0.12) between groups.
Conclusions: FGR with abnormal fetal blood flow followed by very preterm birth is associated with smaller total kidney and medullary kidney volumes, but not with markers of kidney dysfunction or RAAS activation in adolescence. Decreased total kidney and medullary volumes may still precede a long-term decrease in kidney function, and potentially be used as a prognostic marker. A higher resolution version of the Graphical abstract is available as Supplementary information. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/f7f861b1-d148-42e4-9b24-f96a2961b187
- author
- Liefke, Jonas LU ; Heijl, Caroline LU ; Steding Ehrenborg, Katarina LU ; Morsing, Eva LU ; Arheden, Håkan LU and Ley, David LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Pediatric Nephrology
- volume
- 38
- issue
- 6
- pages
- 1855 - 1866
- publisher
- Springer
- external identifiers
-
- pmid:36409369
- scopus:85142348277
- ISSN
- 1432-198X
- DOI
- 10.1007/s00467-022-05785-x
- language
- English
- LU publication?
- yes
- id
- f7f861b1-d148-42e4-9b24-f96a2961b187
- date added to LUP
- 2022-11-25 09:12:47
- date last changed
- 2023-10-26 14:56:20
@article{f7f861b1-d148-42e4-9b24-f96a2961b187, abstract = {{Background: Preterm birth and fetal growth restriction (FGR) are associated with structural and functional kidney changes, increasing long-term risk for chronic kidney disease and hypertension. However, recent studies in preterm children are conflicting, indicating structural changes but normal kidney function. This study therefore assessed kidney structure and function in a cohort of adolescents born very preterm with and without verified FGR.<br/>Methods: Adolescents born very preterm with FGR and two groups with appropriate birthweight (AGA) were included; one matched for gestational week at birth and one born at term. Cortical and medullary kidney volumes and T1 and T2* mapping values were assessed by magnetic resonance imaging. Biochemical markers of kidney function and renin-angiotensin-aldosterone system (RAAS) activation were analyzed.<br/>Results: Sixty-four adolescents were included (13-16 years; 48% girls). Very preterm birth with FGR showed smaller total (66 vs. 75 ml/m2; p = 0.01) and medullary volume (19 vs. 24 ml/m2; p < 0.0001) compared to term AGA. Corticomedullary volume ratio decreased from preterm FGR (2.4) to preterm AGA (2.2) to term AGA (1.9; p = 0.004). There were no differences in T1 or T2* values (all p ≥ 0.34) or in biochemical markers (all p ≥ 0.12) between groups.<br/>Conclusions: FGR with abnormal fetal blood flow followed by very preterm birth is associated with smaller total kidney and medullary kidney volumes, but not with markers of kidney dysfunction or RAAS activation in adolescence. Decreased total kidney and medullary volumes may still precede a long-term decrease in kidney function, and potentially be used as a prognostic marker. A higher resolution version of the Graphical abstract is available as Supplementary information.}}, author = {{Liefke, Jonas and Heijl, Caroline and Steding Ehrenborg, Katarina and Morsing, Eva and Arheden, Håkan and Ley, David}}, issn = {{1432-198X}}, language = {{eng}}, number = {{6}}, pages = {{1855--1866}}, publisher = {{Springer}}, series = {{Pediatric Nephrology}}, title = {{Fetal growth restriction followed by very preterm birth is associated with smaller kidneys but preserved kidney function in adolescence}}, url = {{http://dx.doi.org/10.1007/s00467-022-05785-x}}, doi = {{10.1007/s00467-022-05785-x}}, volume = {{38}}, year = {{2023}}, }