Comparison of Blood Pressure and Kidney Markers between Adolescent Former Preterm Infants and Term Controls.

Eveline Staub,Tatjana Welzel,Katrina S Evers,Natalie Urfer-Maurer,Sakari Lemola,Marc Pfister,Lorenz Risch

doi:10.3390/children7090141

Abstract

Background: Preterm infants are at an increased risk of developing hypertension and chronic kidney disease later in life. No recommendations exist for blood pressure (BP) and renal follow up for these patients. Aim: To compare BP and serum and urinary kidney markers between preterm-born adolescents and term-born controls. Methods: BP measurements in 51 preterm-born (≤32 weeks gestational age) and 82 term-born adolescents at the age of 10–15 years were conducted. Stepwise regression analysis explored the association between BP and participant characteristics. Kidney markers measured in the serum and urine were creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and uromodulin. Kidney markers measured in the serum were cystatin C, beta-2 microglobulin, and beta trace protein. Results: Systolic BP was significantly higher in preterm boys compared with term boys, but not in girls, and low birth weight was associated with higher BP in boys. In the preterm group, maternal hypertension/preeclampsia and adolescent height were associated with higher systolic BP. Serum creatinine and NGAL were significantly higher in the preterm group. Conclusions: Our study confirms an inverse sex-dependant relationship between birth weight and BP at adolescent age. The higher serum creatinine and NGAL in the preterm group may indicate that premature birth affects kidney function in the long term.

Highlights

Infants born at a very young gestational age (GA) and a very low birth weight (VLBW) are at risk for developing renal and cardiovascular diseases when they grow up to adolescents and young adults [1]
Large studies have shown that birth weight (BW) and GA are inversely associated with an increased risk of developing arterial hypertension and chronic kidney disease (CKD) [2]
Routine measurement of blood pressure (BP) is the obvious choice for screening for arterial hypertension. It is unclear whether the assessment of albuminuria and the estimated glomerular filtration rate from serum creatinine capture the early decline in kidney function in preterm-born patients who typically have reduced renal mass with hypertrophied, hyperfiltrating individual glomeruli [4]

Summary

Introduction

Infants born at a very young gestational age (GA) and a very low birth weight (VLBW) are at risk for developing renal and cardiovascular diseases when they grow up to adolescents and young adults [1]. Large studies have shown that birth weight (BW) and GA are inversely associated with an increased risk of developing arterial hypertension and chronic kidney disease (CKD) [2]. Routine measurement of blood pressure (BP) is the obvious choice for screening for arterial hypertension It is unclear whether the assessment of albuminuria and the estimated glomerular filtration rate (eGFR) from serum creatinine capture the early decline in kidney function in preterm-born patients who typically have reduced renal mass with hypertrophied, hyperfiltrating individual glomeruli [4]. Results: Systolic BP was significantly higher in preterm boys compared with term boys, but not in girls, and low birth weight was associated with higher

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