Abstract: TH-PO663

Renal Function and Blood Pressure in Adolescents Born Preterm with Very Low Birth Weight

Session Information

  • Pediatric Nephrology
    November 02, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Developmental Biology and Inherited Kidney Diseases

  • 403 Pediatric Nephrology

Authors

  • South, Andrew M., Wake Forest School of Medicine, Winston Salem, North Carolina, United States
  • Nixon, Patricia A., Wake Forest University, Winston Salem, North Carolina, United States
  • Chappell, Mark C, Wake Forest School of Medicine, Winston Salem, North Carolina, United States
  • Diz, Debra I., Wake Forest School of Medicine, Winston Salem, North Carolina, United States
  • Russell, Gregory B., Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
  • Jensen, Elizabeth T, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
  • Shaltout, Hossam A., Wake Forest School of Medicine, Winston Salem, North Carolina, United States
  • Washburn, Lisa, Wake Forest School of Medicine, Winston Salem, North Carolina, United States
Background

Survival of children born prematurely has improved, but preterm birth as well as low birth weight may increase the risk of developing kidney disease in adulthood. However, the timing of the development of renal dysfunction and its progression is unclear. We hypothesize that worse kidney function will be present in early adolescence in children born preterm with very low birth weight (VLBW) as compared to term controls.

Methods

We measured systolic and diastolic blood pressure (BP), serum creatinine, and urine albumin at age 14 years in 96 subjects born preterm with VLBW (mean birth weight 1048 g) and 43 term controls. We calculated the glomerular filtration rate (GFR) by the Schwartz equation and urine albumin-to-creatinine ratio (ACR). We used generalized linear models to estimate the association between preterm birth and renal function, adjusting for maternal hypertensive pregnancy and socioeconomic status.

Results

In addition to higher mean systolic and diastolic BP (p<0.01 and p=0.03, respectively), adolescents born preterm had significantly-decreased GFR (β: -8.17 mL/min/1.73 m2, 95% CI -15.93 to -0.4) as compared to term controls. Adjustment for covariates attenuated this relationship (β: -6.34 mL/min/1.73 m2, -15.04 to 2.36). While subjects born preterm had higher median ACR, adjustment for potential confounders attenuated this relationship (ln ACR β: 0.34, -0.04 to 0.72).

Conclusion

Higher BP and reduced renal function were present in adolescents born preterm with VLBW compared to term peers, though the association between preterm birth and GFR was weakened after adjusting for confounders. While other factors should be considered, our study provides evidence of an early divergence of renal function during adolescence as a consequence of prematurity.

Funding

  • Other NIH Support