Department of Neonatology, The Townsville Hospital, 100 Angus Smith Drive, Queensland, 4814, Australia.
Pediatr Nephrol. 2013 Sep;28(9):1791-6. doi: 10.1007/s00467-013-2462-3. Epub 2013 Apr 4.
Nephron number in humans is determined during fetal life. The objective of this study was to investigate the effects of preterm birth on nephron number using renal volume as a surrogate for nephron number.
This observational study was conducted over 12 months in a tertiary perinatal center. Preterm babies less than 32 weeks of gestation were recruited and followed until discharge. Term infants were recruited for comparison. The babies underwent renal sonography and renal function measurements at 32 and 38 weeks corrected age. The primary outcome measurement was total kidney volume at 38 weeks and the secondary outcome was estimated glomerular filtration rate (eGFR).
Forty-four preterm infants and 24 term infants were recruited. At 38 weeks corrected age, premature infants had lower total kidney volume than term infants (21.6 ± 5.7 vs. 25.2 ± 5.7 ml; p = 0.02) and a significantly lower eGFR (73.6 [IQR 68.1-77.6] vs. 79.3 [IQR 72.5-86.6] ml·min(-1)·1.73 m(-2); p = 0.03). There was a significant correlation between total kidney volume and eGFR in premature and term babies.
Premature infants have smaller kidney volume and likely decreased nephron number and lower estimated glomerulofiltration rate relative to infants born at term.
人类的肾单位数量在胎儿期就已确定。本研究旨在通过以肾体积作为肾单位数量的替代指标，探讨早产儿出生对肾单位数量的影响。
本观察性研究在一家三级围产医学中心进行，历时 12 个月。招募胎龄小于 32 周的早产儿，并随访至出院。同期招募足月儿作为对照。婴儿在 32 周和 38 周校正胎龄时接受肾脏超声和肾功能检查。主要结局测量指标为 38 周时的总肾体积，次要结局为估算肾小球滤过率（eGFR）。
共招募了 44 例早产儿和 24 例足月儿。在 38 周校正胎龄时，早产儿的总肾体积明显小于足月儿（21.6±5.7 比 25.2±5.7 ml；p=0.02），eGFR 也明显较低（73.6[IQR 68.1-77.6]比 79.3[IQR 72.5-86.6] ml·min(-1)·1.73 m(-2)；p=0.03）。早产儿和足月儿的总肾体积与 eGFR 均呈显著正相关。
与足月儿相比，早产儿的肾脏体积较小，肾单位数量可能减少，估计肾小球滤过率降低。
