Basioti Maria, Giapros Vasileios, Kostoula Angeliki, Cholevas Vasileios, Andronikou Styliani
Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece.
Am J Kidney Dis. 2009 Nov;54(5):850-8. doi: 10.1053/j.ajkd.2009.05.017. Epub 2009 Jul 23.
Individuals born small for gestational age (SGA) are at risk of developing hypertension and kidney disease later in life. The time that this may occur is unknown. This study aims to examine kidney function in preschool children who were SGA.
A case-control study.
SETTINGS & PARTICIPANTS: The study included 100 children, 60 SGA and 40 appropriate-for-gestational-age (AGA) controls matched with the SGA children according to birth characteristics (gestational age and sex) and characteristics at the time of the study (body weight, body height, body mass index, and age). SGA children were classified according to severity of growth restriction into 2 groups: birth weight less than the 3rd percentile (n = 25) and birth weight from the 3rd to 10th percentile (n = 35).
Being SGA and severity of growth restriction at birth.
OUTCOMES & MEASUREMENTS: Kidney function was estimated at a mean age of 5 years by using serum creatinine level; estimated glomerular filtration rate; urinary albumin excretion; fractional excretion of sodium, potassium, phosphate, magnesium, and uric acid; transtubular potassium gradient; and urinary calcium-creatinine ratio calculated from 3-hour urine collections. Blood pressure and kidney length also were measured.
Kidney length, serum creatinine level, and estimated glomerular filtration rate did not differ among the 3 groups. Systolic and diastolic blood pressures were greater in SGA children with birth weight less than the third centile versus controls (107.5 +/- 11 versus 102 +/- 10 mm Hg [P = 0.03] and 69 +/- 7.5 versus 65 +/- 8.6 mm Hg [P = 0.02] for systolic and diastolic blood pressure, respectively). Both groups of SGA children had greater urinary calcium excretion than AGA children (urinary calcium-creatinine ratio, 0.16 +/- 0.08 and 0.16 +/- 0.10 in SGA with birth weight < 3rd and 3rd to 10th percentiles versus 0.10 +/- 0.09 in AGA; P = 0.04 and P = 0.03, respectively). SGA children also had lower uric acid excretion despite greater serum uric acid levels (fractional excretion of uric acid, 7.4% +/- 4% and 6.9% +/- 5% versus 10.5% +/- 5.9%; P = 0.02 and P = 0.003, respectively).
Relatively small sample size, blood pressure was measured on a single visit.
Children born SGA showed alterations in calcium and uric acid urinary excretion at preschool age, and blood pressure was related to the severity of growth restriction.
小于胎龄儿（SGA）出生后在生命后期有患高血压和肾脏疾病的风险。这种情况可能发生的时间尚不清楚。本研究旨在检查SGA学龄前儿童的肾功能。
一项病例对照研究。
该研究纳入了100名儿童，60名SGA儿童和40名适于胎龄（AGA）的对照儿童，后者根据出生特征（胎龄和性别）以及研究时的特征（体重、身高、体重指数和年龄）与SGA儿童匹配。SGA儿童根据生长受限的严重程度分为两组：出生体重低于第3百分位数（n = 25）和出生体重在第3至第10百分位数之间（n = 35）。
为SGA以及出生时生长受限的严重程度。
在平均年龄5岁时，通过血清肌酐水平、估计肾小球滤过率、尿白蛋白排泄、钠、钾、磷酸盐、镁和尿酸的分数排泄、肾小管钾梯度以及根据3小时尿液收集计算的尿钙肌酐比值来评估肾功能。还测量了血压和肾脏长度。
三组之间的肾脏长度、血清肌酐水平和估计肾小球滤过率没有差异。出生体重低于第三百分位数的SGA儿童的收缩压和舒张压高于对照组（收缩压分别为107.5±11与102±10 mmHg [P = 0.03]，舒张压分别为69±7.5与65±8.6 mmHg [P = 0.02]）。两组SGA儿童的尿钙排泄均高于AGA儿童（出生体重<第3百分位数和第3至第10百分位数的SGA儿童的尿钙肌酐比值分别为0.16±0.08和0.16±0.10，而AGA儿童为0.10±0.09；P分别为0.04和0.03）。尽管血清尿酸水平较高，但SGA儿童的尿酸排泄较低（尿酸分数排泄分别为7.4%±4%和6.9%±5%，而AGA儿童为10.5%±5.9%；P分别为0.02和0.003）。
样本量相对较小，血压仅在单次就诊时测量。
SGA出生的儿童在学龄前出现钙和尿酸尿排泄改变，且血压与生长受限的严重程度有关。
