Increased albuminuria in 4-year-old preterm-born children with normal height.

ABSTRACT

OBJECTIVE: To determine risk factors for high blood pressure (BP), increased markers of glomerulosclerosis, and tubular dysfunction in 4-year-old preterm-born children. STUDY DESIGN: The study group was a longitudinal cohort of 119 children with BP, albuminuria, and ß2 microglobulin measurements obtained during the neonatal period and at age 4 years. RESULTS: Systolic BP was >95(th) percentile in 15 (12.6%) of the children at age 4 years and lower in those born small for gestational age compared with those born appropriate for gestational age. Preterm-born 4-year-olds with height <-1 SD had lower systolic and diastolic BP, and 14.4% of the 4-year-olds had albuminuria. Albuminuria was less prevalent in the 4-year-olds with height <-1 SD than in those with height ≥-1 SD (6.8% vs 19.3%; P=.04). Mean albuminuria level was 1.0±0.7 mg/mmol in 4-year-olds with height <-1 SD and 1.4±1.3 mg/mmol in those with height ≥-1 SD. In multivariate analysis, albuminuria level was increased by 0.4±0.2 mg/mmol in preterm-born children with normal height at age 4, and by 0.5±0.2 mg/mmol in females, after adjustment for gestational age, sex, neonatal morbidity, and intrauterine growth restriction. These results were unchanged after adjustment for body mass index. CONCLUSION: Normal height at age 4 years may be associated with an increased risk for glomerulosclerosis in preterm-born children.