Kidneys in 5-year-old preterm-born children: a longitudinal cohort monitoring of renal function.

ABSTRACT

BackgroundBeing aware of the impact of low birth weight on late-onset hypertension, our aim was to describe systolic blood pressure (sBP) and renal function in 3-5-year-old preterm-born children and to determine which perinatal factors or childhood factors were associated with an altered renal function at 5 years in these children.MethodsThis was a prospective longitudinal cohort study of children born at 27-31 weeks of gestation and included at birth and examined at 3, 4, and 5 years of age. The primary outcome was renal function at 5 years BP, estimated glomerular filtration rate, and albuminuria.ResultsOne hundred and sixty five children were examined, of whom 93 (56.4%) were male. Gestational age was 29.2±1.4 weeks and birth weight was 1,217±331 g. Overall, 25% children had sBP ≥90th percentile at age 3 and 4 years and 11% at 5 years. In multivariate analysis, sBP ≥90th percentile at 5 years was associated with the use of antenatal steroids (OR=0.19(0.05;0.65)). There was a significant association between protein intake on day 28 and sBP at 5 years (ß=2.1±1.0, P=0.03). Glomerular filtration rate at 5 years was significantly decreased in case of hyaline membrane disease or necrotizing enterocolitis. High urine albumin was not predictable from one year to another.ConclusionIn preterm-born children, sBP was often high and neonatal protein intake was associated with increased blood pressure during childhood.