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宫内生长受限的新生儿和婴儿的血压和肾功能。

Blood pressure and kidney function in neonates and young infants with intrauterine growth restriction.

机构信息

Faculty of Medicine, University Bonn, Bonn, Germany.

Department of Neonatology and Pediatric Intensive Care, University Hospital Bonn, Bonn, Germany.

出版信息

Pediatr Nephrol. 2023 Apr;38(4):1223-1232. doi: 10.1007/s00467-022-05713-z. Epub 2022 Sep 2.

Abstract

BACKGROUND

Intrauterine growth restriction (IUGR) has been associated with changes in kidney anatomy, nephrogenesis and the vascular system, resulting in secondary arterial hypertension and kidney damage in adulthood. Here, we compare routine clinical and metabolic parameters between IUGR and non-IUGR study participants in the neonatal and early infant period.

METHODS

A total of 39 IUGR and 60 non-IUGR neonates were included during an 18-month study period. We compared blood pressure, serum creatinine (SCr), urea nitrogen (BUN), urinary albumin, α-1-microglobulin, transferrin, immunoglobulin G and total protein excretion in spontaneous urine normalized by urine creatinine level during the hospital stay.

RESULTS

There were no significant differences in mean values of blood pressure and urinary protein excretion between cases and controls. SCr and BUN levels were lower in the IUGR group compared to the non-IUGR group.

CONCLUSIONS

The lower levels of SCr and BUN may be attributed to lower liver and muscle mass in IUGR neonates and young infants. Biomarkers currently used in routine clinical care do not allow early postnatal prediction of higher blood pressure or worse kidney function due to IUGR, so further studies are needed. A higher resolution version of the Graphical abstract is available as Supplementary information.

摘要

背景

宫内生长受限(IUGR)与肾脏解剖结构、肾发生和血管系统的变化有关,导致成年后继发性动脉高血压和肾脏损伤。在这里,我们比较了新生儿和婴儿早期 IUGR 和非 IUGR 研究参与者的常规临床和代谢参数。

方法

在 18 个月的研究期间,共纳入 39 名 IUGR 和 60 名非 IUGR 新生儿。我们比较了住院期间通过尿肌酐水平校正的自发性尿液中血压、血清肌酐(SCr)、尿素氮(BUN)、尿白蛋白、α-1-微球蛋白、转铁蛋白、免疫球蛋白 G 和总蛋白排泄的平均值。

结果

病例组和对照组的血压和尿蛋白排泄平均值无显著差异。与非 IUGR 组相比,IUGR 组的 SCr 和 BUN 水平较低。

结论

IUGR 新生儿和婴儿的肝脏和肌肉质量较低,可能导致 SCr 和 BUN 水平较低。目前在常规临床护理中使用的生物标志物不能早期预测因 IUGR 而导致的更高血压或更差的肾功能,因此需要进一步研究。一个更高分辨率的图表摘要版本可以作为补充信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7eee/9925571/4963f95c75b6/467_2022_5713_Fig1_HTML.jpg

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