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Pediatr Int. 2019 Sep 7. doi: 10.1111/ped.14004. [Epub ahead of print]

Long-term renal follow-up of preterm neonates born before 35 weeks of gestation.

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Division of Pediatrics.
Division of Neonatology, Shimane Prefectural Central Hospital.



The hypothesis of the Developmental Origins of Health and Disease states that environmental factors during fetal and infantile life are risk factors for some chronic diseases in adulthood. However, few studies have confirmed this hypothesis early in childhood. Therefore, we aimed to assess how premature birth and low birth weight (LBW) affect the renal function of Japanese children.


This retrospective study surveyed 168 patients who were born before 35 weeks of gestation and were cared for at our neonatal intensive care unit. Follow-up duration was more than 2 years. Serum creatinine (sCr) levels and estimated glomerular filtration rates (eGFRs) recorded in medical records were reviewed.


The eGFR at 2 years of age was significantly correlated with birth weight and gestational age (p <0.01). Approximately 10.7% of the children had low eGFRs (<90 mL/min/1.73 m2 ) without clinical symptoms and abnormal urine examination results. These children had high sCr levels on day 7 after birth (p <0.01) and delayed recovery of these levels during the first month after birth.


These data suggest that premature gestational age and LBW directly affect the renal function of young children. A high sCr level on day 7 after birth is a risk factor for chronic kidney disease in children. These results indicate that careful follow-up of renal function is required for premature infants and infants with LBW beginning in early childhood to prevent renal dysfunction. This article is protected by copyright. All rights reserved.


chronic kidney disease; estimated glomerular filtration rate; low birth weight; premature birth; small for gestational age


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