Iyengar A, Nesargi S, George A, Sinha N, Selvam S, Luyckx V A
Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, India.
Department of Neonatology, St John's Medical College Hospital, Bangalore, India.
BMC Nephrol. 2016 Jul 26;17(1):100. doi: 10.1186/s12882-016-0314-7.
To assess the renal growth and function of neonates during infancy in relation to birth weight and gestational age.
A longitudinal study was conducted at a tertiary hospital in South India from June 2010 to August 2014. Low birth weight neonates (LBW) were further sub-classified based on gestational age and compared with normal birth weight (NBW) full term neonates at birth, 6 months and 18-24months of age. The renal volume was measured by ultrasound and renal function by Cystatin C- derived glomerular filtration rate (CysGFR) at the three time points during the dynamic phase of renal maturation in infancy.
We recruited 100 LBW and 66 NBW term neonates. Thirty five percent of the LBW neonates were SGA. Among the AGA neonates, 39 % were LBW neonates. The mean height and weight of the LBW neonates were significantly lower compared to NBW neonates throughout infancy. The increment in kidney volume was in accordance with the change in body size, being lower in LBW compared to NBW infants. The combined kidney volume was significantly lower in LBW and SGA neonates across all three time points (p < 0.001). CysGFR in the LBW and SGA infants, despite having low kidney volumes, were comparable to the GFRs of NBW and AGA neonates at the end of infancy.
This study highlights the fact that both birth weight and gestational age influence kidney growth and function in infancy. At the end of infancy, despite a significant difference in kidney volumes and age at last follow up, the glomerular filtration rate was comparable between LBW and NBW infants. Though not statistically significant, there was a trend towards higher urine microalbumin in LBW compared to NBW in infancy.
评估婴儿期新生儿的肾脏生长及功能与出生体重和胎龄的关系。
2010年6月至2014年8月在印度南部一家三级医院开展了一项纵向研究。低出生体重新生儿（LBW）根据胎龄进一步细分，并在出生时、6个月以及18 - 24个月时与正常出生体重（NBW）的足月新生儿进行比较。在婴儿期肾脏成熟的动态阶段的三个时间点，通过超声测量肾脏体积，通过胱抑素C衍生的肾小球滤过率（CysGFR）评估肾功能。
我们招募了100名LBW新生儿和66名NBW足月儿。35%的LBW新生儿为小于胎龄儿（SGA）。在适于胎龄（AGA）新生儿中，39%为LBW新生儿。在整个婴儿期，LBW新生儿的平均身高和体重显著低于NBW新生儿。肾脏体积的增加与身体大小的变化一致，LBW婴儿低于NBW婴儿。在所有三个时间点，LBW和SGA新生儿的双肾体积均显著较低（p < 0.001）。LBW和SGA婴儿的CysGFR，尽管肾脏体积较小，但在婴儿期末与NBW和AGA新生儿的肾小球滤过率相当。
本研究强调了出生体重和胎龄均影响婴儿期肾脏生长和功能这一事实。在婴儿期末，尽管肾脏体积和末次随访时的年龄存在显著差异，但LBW和NBW婴儿的肾小球滤过率相当。虽然无统计学意义，但婴儿期LBW相比NBW有尿微量白蛋白升高的趋势。
