Fetal growth restriction followed by very preterm birth is associated with smaller kidneys but preserved kidney function in adolescence

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Preterm birth and fetal growth restriction (FGR) are associated with structural and functional kidney changes, increasing long-term risk for chronic kidney disease and hypertension. However, recent studies in preterm children are conflicting, indicating structural changes but normal kidney function. This study therefore assessed kidney structure and function in a cohort of adolescents born very preterm with and without verified FGR.
Methods: Adolescents born very preterm with FGR and two groups with appropriate birthweight (AGA) were included; one matched for gestational week at birth and one born at term. Cortical and medullary kidney volumes and T1 and T2* mapping values were assessed by magnetic resonance imaging. Biochemical markers of kidney function and renin-angiotensin-aldosterone system (RAAS) activation were analyzed.
Results: Sixty-four adolescents were included (13-16 years; 48% girls). Very preterm birth with FGR showed smaller total (66 vs. 75 ml/m2; p = 0.01) and medullary volume (19 vs. 24 ml/m2; p < 0.0001) compared to term AGA. Corticomedullary volume ratio decreased from preterm FGR (2.4) to preterm AGA (2.2) to term AGA (1.9; p = 0.004). There were no differences in T1 or T2* values (all p ≥ 0.34) or in biochemical markers (all p ≥ 0.12) between groups.
Conclusions: FGR with abnormal fetal blood flow followed by very preterm birth is associated with smaller total kidney and medullary kidney volumes, but not with markers of kidney dysfunction or RAAS activation in adolescence. Decreased total kidney and medullary volumes may still precede a long-term decrease in kidney function, and potentially be used as a prognostic marker. A higher resolution version of the Graphical abstract is available as Supplementary information.
Original languageEnglish
Pages (from-to)1855-1866
JournalPediatric Nephrology
Volume38
Issue number6
Early online date2022 Nov 21
DOIs
Publication statusPublished - 2023

Subject classification (UKÄ)

  • Pediatrics
  • Urology and Nephrology
  • Radiology, Nuclear Medicine and Medical Imaging

Fingerprint

Dive into the research topics of 'Fetal growth restriction followed by very preterm birth is associated with smaller kidneys but preserved kidney function in adolescence'. Together they form a unique fingerprint.

Cite this