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Pediatr Nephrol. 2019 Jan;34(1):137-144. doi: 10.1007/s00467-018-4050-z. Epub 2018 Aug 15.

Renal function and blood pressure are altered in adolescents born preterm.

Author information

1
Department of Pediatrics, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, USA. asouth@wakehealth.edu.
2
Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston-Salem, NC, USA. asouth@wakehealth.edu.
3
Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA. asouth@wakehealth.edu.
4
Department of Pediatrics, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
5
Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA.
6
Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston-Salem, NC, USA.
7
Department of Surgery-Hypertension and Vascular Research, Wake Forest School of Medicine, Winston-Salem, NC, USA.
8
Division of Public Health Sciences, Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
9
Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
10
Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
11
Department of Pharmacology and Toxicology, School of Pharmacy, University of Alexandria, Alexandria, Egypt.
12
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

Preterm birth increases the risk of hypertension and kidney disease. However, it is unclear when changes in blood pressure (BP) and renal function become apparent and what role obesity and sex play. We hypothesized adolescents born preterm have higher BP and worse kidney function compared to term in an obesity- and sex-dependent manner.

METHODS:

Cross-sectional analysis of 14-year-olds born preterm with very low birth weight (n = 96) compared to term (n = 43). We used generalized linear models to estimate the associations among preterm birth and BP, estimated glomerular filtration rate (eGFR), and ln (x) urinary albumin-to-creatinine ratio (ACR), stratified by overweight/obesity (OWO, body mass index (BMI) ≥ 85th percentile) and sex.

RESULTS:

Compared to term, preterm-born adolescents had higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) (adjusted β (aβ) 3.5 mmHg, 95% CI - 0.1 to 7.2 and 3.6 mmHg, 95% CI 0.1 to 7.0), lower eGFR (β - 8.2 mL/min/1.73 m2, 95% CI - 15.9 to - 0.4), and higher ACR (aβ 0.34, 95% CI - 0.04 to 0.72). OWO modified the preterm-term difference in DBP (BMI < 85th percentile aβ 5.0 mmHg, 95% CI 0.7 to 9.2 vs. OWO 0.2 mmHg, 95% CI - 5.3 to 5.6) and ACR (OWO aβ 0.72, 95% CI 0.15 to 1.29 vs. BMI < 85th percentile 0.17, 95% CI - 0.31 to 0.65). Sex modified the preterm-term ACR difference (female aβ 0.52, 95% CI 0.001 to 1.04 vs. male 0.18, 95% CI - 0.36 to 0.72).

CONCLUSIONS:

Prematurity was associated with higher BP and reduced renal function that were detectable in adolescence. OWO and sex may modify the strength of these relationships.

KEYWORDS:

Chronic kidney disease; Hypertension; Obesity; Programming; Sex differences; Very low birth weight

PMID:
30112655
PMCID:
PMC6237649
[Available on 2020-01-01]
DOI:
10.1007/s00467-018-4050-z

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