Download PDF
Am J Perinatol 2012; 29(02): 115-120
DOI: 10.1055/s-0031-1295651
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Oligonephropathy of Prematurity

Yogavijayan Kandasamy
1   Department of Neonatology, The Townsville Hospital, Douglas, Queensland;
,
Roger Smith
2   Mother and Babies’ Research Centre, Hunter Medical Research Institute, John Hunter Hospital;
,
Ian M.R. Wright
2   Mother and Babies’ Research Centre, Hunter Medical Research Institute, John Hunter Hospital;
3   Discipline of Paediatrics and Child Health, University of Newcastle, Newcastle, New South Wales, Australia.
› Author Affiliations
Further Information

Publication History

28 April 2011

07 July 2011

Publication Date:
17 November 2011 (online)

    Permissions and Reprints

Abstract

With improved health care, the number of premature babies who survive to adulthood is expected to increase. The objective of this review is to determine whether premature infants have an increased risk of chronic kidney disease (CKD). A literature review was performed by searching PubMed (U.S. National Library of Medicine) and the Cochrane Library, using the keywords “prematurity,” “kidney,” “nephrogenesis,” “oligonephropathy,” and “kidney impairment.” Articles published in English since 1990 were reviewed. Increasing evidence suggests that prematurity causes oligonephropathy independently of, and coexisting with, intrauterine growth restriction. Animal studies show that nephrogenesis continues for up to 3 weeks in extrauterine life, but with up to 18% abnormal glomeruli. Nephrogenesis is further impaired in preterm infants who develop renal impairment in the early postnatal period, which is estimated to be 8 to 24%. Premature infants are at risk for CKD. A larger longitudinal study is needed that follows up premature infants to determine the exact incidence of CKD. Until then, renal assessment in premature infants should be incorporated into follow-up guidelines, in addition to the current assessment of growth and neurodevelopmental outcomes. The cost implications to a comprehensive program, impact of early identification, and strategies to improve outcomes in this population are needed.

Keywords

oligonephropathy - preterm - nephrogenesis - chronic kidney disease
 

  • References

  • 1 Beck S, Wojdyla D, Say L , et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ 2010; 88: 31-38
    Google Scholar
  • 2 International Classification of Diseases and Related Health Problems; . 10th revision. Geneva: World Health Organization; 1992
  • 3 Franke D, Völker S, Haase S , et al. Prematurity, small for gestational age and perinatal parameters in children with congenital, hereditary and acquired chronic kidney disease. Nephrol Dial Transplant 2010; 25: 3918-3924
    CrossrefPubMedGoogle Scholar
  • 4 Bagby SP. Developmental origins of renal disease: should nephron protection begin at birth?. Clin J Am Soc Nephrol 2009; 4: 10-13
    CrossrefPubMedGoogle Scholar
  • 5 Hoy WE, Rees M, Kile E, Mathews JD, Wang Z. A new dimension to the Barker hypothesis: low birthweight and susceptibility to renal disease. Kidney Int 1999; 56: 1072-1077
    CrossrefPubMedGoogle Scholar
  • 6 White SL, Perkovic V, Cass A , et al. Is low birth weight an antecedent of CKD in later life? A systematic review of observational studies. Am J Kidney Dis 2009; 54: 248-261
    Google Scholar
  • 7 Hoy WE, Rees M, Kile E , et al. Low birthweight and renal disease in Australian aborigines. Lancet 1998; 352: 1826-1827
    CrossrefPubMedGoogle Scholar
  • 8 Hughson M, Farris III AB, Douglas-Denton R, Hoy WE, Bertram JF. Glomerular number and size in autopsy kidneys: the relationship to birth weight. Kidney Int 2003; 63: 2113-2122
    CrossrefPubMedGoogle Scholar
  • 9 Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure. Less of one, more the other?. Am J Hypertens 1988; 1 (4 Pt 1) 335-347
    CrossrefPubMedGoogle Scholar
  • 10 Bacchetta J, Harambat J, Guy B, Putet G, Cochat P, Dubourg L. [Long term renal outcome of children born preterm: a regular follow-up is needed]. Arch Pediatr 2009; 16 ( Suppl (Suppl. 01) S42-S48
    CrossrefPubMedGoogle Scholar
  • 11 Gubhaju L, Sutherland MR, Black MJ. Preterm birth and the kidney: implications for long-term renal health. Reprod Sci 2011; 18: 322-333
    CrossrefPubMedGoogle Scholar
  • 12 Gubhaju L, Sutherland MR, Yoder BA, Zulli A, Bertram JF, Black MJ. Is nephrogenesis affected by preterm birth? Studies in a non-human primate model. Am J Physiol Renal Physiol 2009; 297: F1668-F1677
    CrossrefPubMedGoogle Scholar
  • 13 Monte JC, Sakurai H, Bush KT, Nigam SK. The developmental nephrome: systems biology in the developing kidney. Curr Opin Nephrol Hypertens 2007; 16: 3-9
    CrossrefPubMedGoogle Scholar
  • 14 Hinchliffe SA, Sargent PH, Howard CV, Chan YF, van Velzen D. Human intrauterine renal growth expressed in absolute number of glomeruli assessed by the disector method and Cavalieri principle. Lab Invest 1991; 64: 777-784
    PubMedGoogle Scholar
  • 15 Shah MM, Sampogna RV, Sakurai H, Bush KT, Nigam SK. Branching morphogenesis and kidney disease. Development 2004; 131: 1449-1462
    CrossrefPubMedGoogle Scholar
  • 16 Bestic M, Reed MD. The ontogeny of human kidney development: influence on neonatal diuretic therapy. NeoReviews 2005; 6: 363-368
    CrossrefPubMedGoogle Scholar
  • 17 Cheong HI, Cho HY, Kim JH, Yu YS, Ha IS, Choi Y. A clinico-genetic study of renal coloboma syndrome in children. Pediatr Nephrol 2007; 22: 1283-1289
    CrossrefPubMedGoogle Scholar
  • 18 Gubhaju L, Black MJ. The baboon as a good model for studies of human kidney development. Pediatr Res 2005; 58: 505-509
    CrossrefPubMedGoogle Scholar
  • 19 Huang HP, Tsai IJ, Lai YC, Cheng CH, Tsau YK. Early postnatal renal growth in premature infants. Nephrology (Carlton) 2007; 12: 572-575
    CrossrefPubMedGoogle Scholar
  • 20 Sutherland MR, Gubhaju L, Yoder BA, Stahlman MT, Black MJ. The effects of postnatal retinoic acid administration on nephron endowment in the preterm baboon kidney. Pediatr Res 2009; 65: 397-402
    CrossrefPubMedGoogle Scholar
  • 21 Ortiz LA, Quan A, Weinberg A, Baum M. Effect of prenatal dexamethasone on rat renal development. Kidney Int 2001; 59: 1663-1669
    CrossrefPubMedGoogle Scholar
  • 22 Zhang J, Massmann GA, Rose JC, Figueroa JP. Differential effects of clinical doses of antenatal betamethasone on nephron endowment and glomerular filtration rate in adult sheep. Reprod Sci 2010; 17: 186-195
    CrossrefPubMedGoogle Scholar
  • 23 Gilbert TL-PM, Lelievre-Pegorier M, Merlet-Benichou C. Immediate and long-term renal effects of fetal exposure to gentamicin. Pediatr Nephrol 1990; 4: 445-450
    CrossrefPubMedGoogle Scholar
  • 24 Baud O. Antenatal corticosteroid therapy: benefits and risks. Acta Paediatr Suppl 2004; 93: 6-10
    PubMedGoogle Scholar
  • 25 Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE. Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 2004; 7: 17-25
    PubMedGoogle Scholar
  • 26 Faa G, Gerosa C, Fanni D , et al. Marked interindividual variability in renal maturation of preterm infants: lessons from autopsy. J Matern Fetal Neonatal Med 2010; 23 (3) , Suppl (Suppl. 03) 129-133
    CrossrefPubMedGoogle Scholar
  • 27 Luyckx VA, Brenner BM. The clinical importance of nephron mass. J Am Soc Nephrol 2010; 21: 898-910
    CrossrefPubMedGoogle Scholar
  • 28 Askenazi DJ, Ambalavanan N, Goldstein SL. Acute kidney injury in critically ill newborns: what do we know? What do we need to learn?. Pediatr Nephrol 2009; 24: 265-274
    CrossrefPubMedGoogle Scholar
  • 29 Brenner BM, Lawler EV, Mackenzie HS. The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 1996; 49: 1774-1777
    CrossrefPubMedGoogle Scholar
  • 30 Manktelow B, Draper ES, Field C, Field D. Estimates of length of neonatal stay for very premature babies in the UK. Arch Dis Child Fetal Neonatal Ed 2010; 95: F288-F292
    CrossrefPubMedGoogle Scholar
  • 31 Andreoli SP. Acute renal failure in the newborn. Semin Perinatol 2004; 28: 112-123
    CrossrefPubMedGoogle Scholar
  • 32 Askenazi DJ, Griffin R, McGwin G, Carlo W, Ambalavanan N. Acute kidney injury is independently associated with mortality in very low birthweight infants: a matched case-control analysis. Pediatr Nephrol 2009; 24: 991-997
    CrossrefPubMedGoogle Scholar
  • 33 Keijzer-Veen MG, Devos AS, Meradji M, Dekker FW, Nauta J, van der Heijden BJ. Reduced renal length and volume 20 years after very preterm birth. Pediatr Nephrol 2010; 25: 499-507
    CrossrefPubMedGoogle Scholar
  • 34 Greenbaum LA, Muñoz A, Schneider MF , et al. The association between abnormal birth history and growth in children with CKD. Clin J Am Soc Nephrol 2011; 6: 14-21
    CrossrefPubMedGoogle Scholar
  • 35 Rennke HG, Klein PS. Pathogenesis and significance of nonprimary focal and segmental glomerulosclerosis. Am J Kidney Dis 1989; 13: 443-456
    PubMedGoogle Scholar
  • 36 Hodgin JB, Rasoulpour M, Markowitz GS, D’Agati VD. Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 2009; 4: 71-76
    CrossrefPubMedGoogle Scholar
  • 37 British Association of Perinatal Medicine. . Position statement on early care of the newborn. London: BAPM; 2005 . Available at: http://www.bapm.org/publications/ . Accessed October 7, 2010
    PubMed
  • 38 Doyle LW, Anderson PJ. Adult outcome of extremely preterm infants. Pediatrics 2010; 126: 342-351
    CrossrefPubMedGoogle Scholar
  • 39 Stoll BJ, Hansen NI, Bell EF , et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126: 443-456
    CrossrefPubMedGoogle Scholar
  • 40 Drukker A, Guignard JP. Renal aspects of the term and preterm infant: a selective update. Curr Opin Pediatr 2002; 14: 175-182
    CrossrefPubMedGoogle Scholar
  • 41 Keijzer-Veen MG, Dülger A, Dekker FW, Nauta J, van der Heijden BJ. Very preterm birth is a risk factor for increased systolic blood pressure at a young adult age. Pediatr Nephrol 2010; 25: 509-516
    CrossrefPubMedGoogle Scholar
  • 42 Hogg RJ. Screening for CKD in children: a global controversy. Clin J Am Soc Nephrol 2009; 4: 509-515
    CrossrefPubMedGoogle Scholar
  • 43 Redon J. Measurement of microalbuminuria—what the nephrologist should know. Nephrol Dial Transplant 2006; 21: 573-576
    CrossrefPubMedGoogle Scholar
  • 44 Puddu M, Podda MF, Mussap M, Tumbarello R, Fanos V. Early detection of microalbuminuria and hypertension in children of very low birthweight. J Matern Fetal Neonatal Med 2009; 22: 83-88
    CrossrefPubMedGoogle Scholar
  • 45 Askenazi DJ, Feig DI, Graham NM, Hui-Stickle S, Goldstein SL. 3–5 year longitudinal follow-up of pediatric patients after acute renal failure. Kidney Int 2006; 69: 184-189
    CrossrefPubMedGoogle Scholar
  • 46 Puddu M, Fanos V, Podda F, Zaffanello M. The kidney from prenatal to adult life: perinatal programming and reduction of number of nephrons during development. Am J Nephrol 2009; 30: 162-170
    CrossrefPubMedGoogle Scholar
  • 47 Russell RB, Green NS, Steiner CA , et al. Cost of hospitalization for preterm and low birth weight infants in the United States. Pediatrics 2007; 120: e1-e9
    CrossrefPubMedGoogle Scholar
  • 48 Obrador GT, Mahdavi-Mazdeh M, Collins AJ ; Global Kidney Disease Prevention Network. Establishing the Global Kidney Disease Prevention Network (KDPN): a position statement from the National Kidney Foundation. Am J Kidney Dis 2011; 57: 361-370
    CrossrefPubMedGoogle Scholar
  • 49 Ruilope LM. Angiotensin receptor blockers: RAAS blockade and renoprotection. Curr Med Res Opin 2008; 24: 1285-1293
    CrossrefPubMedGoogle Scholar