title: What about the renal function during childhood of children born from dialysed mothers?
abstract: BACKGROUND
  Pregnancy during dialysis is a high-risk condition which is becoming more and more common. The renal outcome of children born from such pregnancies needs to be investigated since renal development may be affected (i.e. exposure to uraemic toxins, therapies, intermittent haemodynamic changes during sessions, prematurity, growth retardation).
  
  
  METHODS
  We performed a single-centre prospective global and renal evaluation (inulin clearance or 2009 Schwartz formula in children <4 years) in 10 children from 7 mothers who underwent haemodialysis during pregnancy.
  
  
  RESULTS
  The median (range) age of mothers at the beginning of pregnancy was 30 (22-33) years, with maximal weekly haemodialysis duration of 18 (12-30) h. Systemic arterial hypertension was reported in 4 of 10 pregnancies, polyhydramnios in 3 and oligohydramnios in 1. The median (range) gestational age was 32 (29-39) weeks of gestation (WG). Seven children were born before 36 WG. The median (range) birth weight (BW) was 1735 (930-3430)g, and eight children had a BW <2500 g. One child had a PAX2 mutation requiring early renal transplantation and was thus excluded from further analysis. Even though glomerular filtration rate and blood pressure were normal in all other children, a significant urine albumin-to-creatinine ratio was found in three children and an increased urine beta-2-microglobulin concentration in an additional one, questioning the presence of an underlying silent reduction in nephron number.
  
  
  CONCLUSIONS
  Despite the small number of patients, this pilot study highlights the potential risk of renal impairment in children born from dialysed mothers. Further studies are required but until then, careful monitoring of these children is important.
authors.affiliation: Service de Néphrologie et Rhumatologie Pédiatriques, Centre de Référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Abou-Jaoude
authors.forename: Laurence
authors.initials: L
authors.lastname: Dubourg
authors.forename: Lucie
authors.initials: L
authors.lastname: Bessenay
authors.forename: Adeline
authors.initials: A
authors.lastname: Pinçon
authors.forename: Anne
authors.initials: A
authors.lastname: Jolivot
authors.forename: Fitsum
authors.initials: F
authors.lastname: Guebre-Egziabher
authors.forename: Pierre
authors.initials: P
authors.lastname: Cochat
authors.forename: Justine
authors.initials: J
authors.lastname: Bacchetta
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000209:etiology* / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D009035:Mothers; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors; D055815:Young Adult; D001613:beta 2-Microglobulin / Q000378:metabolism
chemical_list: D001613:beta 2-Microglobulin; D003404:Creatinine