Is nephrocalcinosis in preterm neonates harmful for long-term blood pressure and renal function?
Pediatrics (English Edition) , Volume 119 - Issue 3 p. 468- 475
OBJECTIVE. The aim of our study was to examine long-term effects of nephrocalcinosis in prematurely born children. PATIENTS AND METHODS. Preterm neonates (gestational age <32 weeks) with (n = 42) and without (n = 32) nephrocalcinosis were prospectively studied at a mean age of 7.5 (±1.0) years. RESULTS. Blood pressure did not differ in ex-preterm infants with and without nephrocalcinosis but was significantly higher than expected for healthy children. In comparison to healthy children, more ex-preterm infants with neonatal nephrocalcinosis had (mild) chronic renal insufficiency (glomerular filtration rate: <85 mL/min per 1.73 m2; 6 of 40); this is in contrast to ex-preterm infants without neonatal nephrocalcinosis (2 of 32). Tubular phosphate reabsorption and plasma bicarbonate were significantly lower in children with nephrocalcinosis compared with children without nephrocalcinosis. In addition, more ex-preterm infants with and without nephrocalcinosis than expected had low values for plasma bicarbonate and early-morning urine osmolality compared with healthy children. Kidney length of ex-preterm infants with and without nephrocalcinosis was significantly smaller than expected in healthy children of the same height. Nephrocalcinosis persisted long-term in 4 of 42 children but was not related to blood pressure, kidney length, or renal function. CONCLUSIONS. Nephrocalcinosis in preterm neonates can have long-term sequelae for glomerular and tubular function. Furthermore, prematurity per se is associated with high blood pressure, relatively small kidneys, and (distal) tubular dysfunction. Long-term follow-up of blood pressure and renal glomerular and tubular function of preterm neonates, especially with neonatal nephrocalcinosis, seems warranted. Copyright
|Blood pressure, Child, Nephrocalcinosis, Preterm infants, Renal failure|
|Pediatrics (English Edition)|
|Organisation||Erasmus MC: University Medical Center Rotterdam|
Kist-Van Holthe, J.E, van Zwieten, P.H.T, Schell-Feith, E.A, Zonderland, H.M, Holscher, H.C, Wolterbeekg, R, … van der Heijden, A.J. (2007). Is nephrocalcinosis in preterm neonates harmful for long-term blood pressure and renal function?. Pediatrics (English Edition), 119(3), 468–475. doi:10.1542/peds.2006-2639