title: Assessment of long-term renal complications in extremely low birth weight children.
abstract: We assessed the long-term renal complications in a regional cohort of extremely low birth weight (ELBW) children born in 2002-2004. The study group, comprising 78 children born as ELBW infants (88% of the available cohort), was evaluated with measurement of serum cystatin C, urinary albumin excretion, renal ultrasound, and 24-h ambulatory blood pressure measurements. The control group included 38 children born full-term selected from one general practice in the district. Study patients were evaluated at a mean age of 6.7 years, and had a median birthweight of 890 g (25th-75th percentile: 760-950 g) and a median gestational age of 27 weeks (25th-75th percentile: 26-29 weeks). Mean serum cystatin C levels were significantly higher (0.64 vs. 0.59 mg/l; p = 0.01) in the ELBW group. Hypertension was diagnosed in 8/78 ELBW and 2/38 of the control children (p = 0.5). Microalbuminuria (>20 mg/g of creatinine) was detected only in five ELBW children (p = 0.17). The mean renal volume was significantly lower in the ELBW group (absolute kidney volume 81 ml vs. 113 ml; p < 0.001, relative kidney volume 85 vs. 97%; p < 0.001). Abnormally small kidneys (<2/3 of predicted size) were detected in 19 ELBW and four control children (p = 0.08). Multivariate logistic regression revealed that the only independent risk factor for renal complications was weight gained during neonatal hospitalization (odds ratio: 0.67; 95% confidence interval: 0.39-0.94). Serum cystatin C and kidney volume are significantly lower in school-age ELBW children. It is important to include systematic renal evaluation in the follow-up programs of ELBW infants.
authors: Department of Pediatrics, Polish-American Children's Hospital Jagiellonian University Medical College, Wielicka 265, Cracow 30-663, Poland. kwintap@mp.pl
authors: Przemko
authors: P
authors: Kwinta
authors: Małgorzata
authors: M
authors: Klimek
authors: Dorota
authors: D
authors: Drozdz
authors: Andrzej
authors: A
authors: Grudzień
authors: Mateusz
authors: M
authors: Jagła
authors: Magdalena
authors: M
authors: Zasada
authors: Jacek Jozef
authors: JJ
authors: Pietrzyk
mesh_terms: D000367:Age Factors; D000375:Aging; D000419:Albuminuria / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000209:etiology; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D009929:Organ Size; D011044:Poland; D018570:Risk Assessment; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C