Department of Medicine, HMRC 260, University of Alberta, Edmonton, Canada, T6G 2S2.
J Am Soc Nephrol. 2010 Jun;21(6):898-910. doi: 10.1681/ASN.2009121248. Epub 2010 Feb 11.
Abundant evidence supports the association between low birth weight (LBW) and renal dysfunction in humans. Anatomic measurements of infants, children, and adults show significant inverse correlation between LBW and nephron number. Nephron numbers are also lower in individuals with hypertension compared with normotension among white and Australian Aboriginal populations. The relationship between nephron number and hypertension among black individuals is still unclear, although the high incidence of LBW predicts low nephron number in this population as well. LBW, a surrogate for low nephron number, also associates with increasing BP from childhood to adulthood and increasing risk for chronic kidney disease in later life. Because nephron numbers can be counted only postmortem, surrogate markers such as birth weight, prematurity, adult height, reduced renal size, and glomerulomegaly are potentially useful for risk stratification, for example, during living-donor assessment. Because early postnatal growth also affects subsequent risk for higher BP or reduced renal function, postnatal nutrition, a potentially modifiable factor, in addition to intrauterine effects, has significant influence on long-term cardiovascular and renal health.
大量证据支持低出生体重 (LBW) 与人类肾功能障碍之间的关联。对婴儿、儿童和成人的解剖测量表明，LBW 与肾单位数量呈显著负相关。与血压正常者相比，白人和澳大利亚原住民中高血压患者的肾单位数量也较低。尽管 LBW 的高发病率也预示着该人群的肾单位数量较低，但黑人群体中肾单位数量与高血压之间的关系仍不清楚。LBW 是肾单位数量低的替代指标，它也与从儿童期到成年期的血压升高以及晚年患慢性肾脏病的风险增加有关。由于只能在死后才能计算肾单位数量，因此，出生体重、早产、成人身高、肾脏缩小和肾小球肥大等替代标志物对于风险分层可能很有用，例如在活体供者评估期间。由于出生后早期生长也会影响随后发生更高血压或肾功能降低的风险，因此，除了宫内影响外，出生后营养（一种潜在的可改变因素）对长期心血管和肾脏健康有重要影响。
