BACKGROUND: Many studies have demonstrated the association between low birth weight (LBW) and chronic kidney disease, estimated glomerular filtration rate (eGFR) and kidney volume (KV). However, studies on twins and those investigating numerous perinatal factors beyond LBW, and their associations with various kidney parameters are scarce. METHODS: A two-center cross-sectional study on five-year-old LBW children was conducted between 2021 and 2023. 110 children were enrolled (8 LBW, 58 very LBW (VLBW), 44 extremely LBW (ELBW)); 56 were twins. We examined associations between birth weight (BW), various prenatal, perinatal and postnatal factors, and eGFR, KV, tubular abnormalities and kidney ultrasound abnormalities, both in singletons and twins. RESULTS: In children with ELBW, eGFR correlated with BW (r = 0.55, P = 0.0018), while in those with BW ≥ 1000 g, eGFR remained constant. Other factors associated with decreased eGFR were hypertensive disorder of pregnancy (93.86 vs. 87.26 ml/min/1.73m2, P = 0.0285) in singletons, decreased growth velocity (β = 0.83, P = 0.0277) in twins, and lower total KV (tKV) and relative KV (rKV) in both singletons (r = 0.60, P < 0.0001 for tKV and r = 0.45, P = 0.0010 for rKV) and twins (β = 0.34, P < 0.0001 for tKV and β = 0.23, P = 0.0002 for rKV). Based on the multivariable models excluding KV, BW and gestational age were associated with eGFR in singletons, while male gender, BW, growth velocity, and coffee drinking during pregnancy were associated with eGFR in twins. However, in models that included KV, BW, gestational age and growth velocity were no longer significant. Total KV was associated with BW (r = 0.39, P = 0.0050 for singletons; β = 2.85, P < 0.0001 for twins), body mass index (r = 0.34, P = 0.0145 for singletons; β = 8.44, P < 0.0001 for twins), and growth velocity (β = 1.43, P = 0.0078). Twins born small for gestational age had lower tKV (70.88 vs 89.20 ml, P < 0.0001). Relative KV showed similar associations. Relative kidney volumes were significantly lower for both kidneys compared to the reference population (55.02 vs 65.42 ml/m2, P < 0.0001 for right kidney and 61.12 vs 66.25 ml/m2, P = 0.0015 for left kidney); however, only 8.6% of children had rKV below 10th percentile. CONCLUSION: Many factors affect eGFR and KV, some of them differ between twins and singletons. Based on multivariable models, eGFR seems to be better predicted by KV than by BW and gestational age in LBW children. Relative kidney volumes were significantly lower in our cohort compared to the reference population, but only 8.6% of rKV were below 10th percentile.
- MeSH
- chronická renální insuficience epidemiologie etiologie patofyziologie MeSH
- dvojčata MeSH
- hodnoty glomerulární filtrace * MeSH
- ledviny * diagnostické zobrazování patofyziologie MeSH
- lidé MeSH
- novorozenec s nízkou porodní hmotností * MeSH
- novorozenec MeSH
- porodní hmotnost MeSH
- předškolní dítě MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- velikost orgánu MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- předškolní dítě MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- MeSH
- lidé MeSH
- nefrologie * dějiny MeSH
- pediatrie * dějiny MeSH
- významné osobnosti MeSH
- Check Tag
- lidé MeSH
- O autorovi
- Drukker, Alfred, 1932-2020 Autorita
Autoři definují pojem prehypertenze (PHT) a hypertenze (HT), uvedena je jejich prevalence u dětí a dospělých. Upozorňujeme na tzv. programming PHT a HT již v prenatálním a časném postnatálním období. Uveden je přehled konzumace soli u nás a ve světě ve vztahu k PHT a HT a komplikacím kardiovaskulárních onemocnění (KVO). Je vysvětlen pojem senzitivita, resp. rezistence při nadměrné dodávce soli podmiňující vzestup krevního tlaku (TK). Stručně jsou uvedeny názory na patofyziologii PHT a HT, shrnuta fakta o konzumaci soli v historii a současnosti a možnosti prevence KVO. Rizika PHT/HT jsou v současnosti spojena s narůstajícím výskytem nadváhy/obezity u dětí a dorostu, ty jsou často spojeny s vysokou konzumací nejen soli, ale i cukru. Shrnujeme zásady primární prevence PHT/HT a komplikací KVO se zdůrazněním nefarmakologické intervence. Prevence by měla začít již ve věku, kdy o jedince pečují pediatři.
The definition and diagnostics of prehypertension (pHt), hypertension (Ht) and their prevalence in children and adults are presented. attention was drawn to the pHt and Ht programming already in the prenatal and early postnatal period. an overview of very high salt consumption in the czech republic and in the world which is connected with pHt, Ht and later with complications of cardiovascular diseases (cVd). the concept of salt sensitivity/ resistance is explained. Briefly presented are opinions on the pathophysiology of hypertension. summarized are the facts about salt consumption in history and the present and possibility of cVd prevention. recently, the risk of pHt/Ht is currently associated with the increasing incidence of overweight/obesity in children and adolescents, who are often associated with high consumption of not only salt, but also sugar. summarized are principles of primary prevention of pHt/Ht and complications of cVd with emphasis on early non-pharmacological intervention. prevention of pHt/ Ht should start already at the age when the individual health care is provided by pediatricians.
- MeSH
- dieta s nízkým obsahem soli MeSH
- dítě MeSH
- dospělí MeSH
- hypertenze * diagnóza patofyziologie prevence a kontrola MeSH
- kuchyňská sůl * škodlivé účinky MeSH
- lidé MeSH
- měření krevního tlaku MeSH
- prehypertenze diagnóza prevence a kontrola MeSH
- prevalence MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
It is known that prematurity and low birth weight are associated with chronic kidney disease and hypertension. A positive correlation between kidney volume and birth weight was also described. In our ongoing observational study in 5-year-old children, we perceived highly abnormal kidney ultrasound and functions of a male patient born weighing 370 grams. It was his first nephrology examination since discharge from the hospital. We believe that thorough follow up and timely diagnosis of developing renal insufficiency may help us to initiate proper treatment in high-risk children (Tab. 1, Fig. 1, Ref. 7).
- MeSH
- dítě MeSH
- hypertenze * epidemiologie MeSH
- krevní tlak MeSH
- lidé MeSH
- vývoj dítěte MeSH
- vývoj plodu MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
