Wallace Samantha W, Geers Erica R, Niehaus Jason Z, Cristea A Ioana, Starr Michelle C
Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Indiana University School of Medicine, Indianapolis, IN, USA.
Pediatr Res. 2024 Oct 24. doi: 10.1038/s41390-024-03638-x.
To describe kidney outcomes in a cohort of children with bronchopulmonary dysplasia (BPD).
We assessed short-term (acute kidney injury defined using neonatal KDIGO criteria) and long-term kidney outcomes, including chronic kidney disease (defined as a GFR < 90 ml/min/1.73 m), albuminuria, and hypertension in a single-center retrospective cohort of children with BPD born between 2010 and 2020.
309 (38.8%) of 797 children included in the cohort had acute kidney injury (AKI) during their NICU admission. Kidney specific follow-up evaluation was infrequent in this cohort; 52.4% of patients had serum creatinine testing and 31.5% had a urinalysis performed after discharge. 163 (32.0%) of 510 patients with long-term data had CKD, which occurred at a median age of 2.2 years. An abnormal eGFR occurred in 31.7%, proteinuria in 12.5% and hypertension in 15.2%.
Children with BPD had high frequencies of AKI and CKD. While the retrospective nature and single-center convenience cohort design limit generalizability, our findings suggest that children with BPD should be carefully monitored for short- and long-term kidney outcomes, including CKD.
Children with bronchopulmonary dysplasia (BPD) may have a higher likelihood of both acute and chronic kidney complications than currently recognized. Kidney outcomes in children with BPD is an area that remains underexplored. To our knowledge, this is the first study exploring the prevalence of CKD in a cohort of children with BPD. Our findings suggest children with BPD have high rates of kidney complications in early childhood. Increased attention should be placed on monitoring children with BPD for both short- and long-term kidney outcomes.
描述一组支气管肺发育不良（BPD）儿童的肾脏结局。
我们评估了短期（使用新生儿KDIGO标准定义的急性肾损伤）和长期肾脏结局，包括慢性肾脏病（定义为肾小球滤过率<90 ml/min/1.73 m²）、蛋白尿和高血压，研究对象为2010年至2020年在单中心出生的BPD儿童回顾性队列。
队列中的797名儿童中有309名（38.8%）在新生儿重症监护病房住院期间发生了急性肾损伤（AKI）。该队列中针对肾脏的随访评估较少；52.4%的患者出院后进行了血清肌酐检测，31.5%的患者进行了尿液分析。510名有长期数据的患者中有163名（32.0%）患有慢性肾脏病，发病中位年龄为2.2岁。估算肾小球滤过率异常的发生率为31.7%，蛋白尿为12.5%，高血压为15.2%。
BPD儿童急性肾损伤和慢性肾脏病的发生率较高。虽然回顾性研究性质和单中心便利样本队列设计限制了研究结果的普遍性，但我们的研究结果表明，应对BPD儿童的短期和长期肾脏结局，包括慢性肾脏病进行仔细监测。
支气管肺发育不良（BPD）儿童发生急性和慢性肾脏并发症的可能性可能比目前认识到的更高。BPD儿童的肾脏结局是一个尚未充分探索的领域。据我们所知，这是第一项探索BPD儿童队列中慢性肾脏病患病率的研究。我们的研究结果表明，BPD儿童在幼儿期肾脏并发症发生率较高。应更加重视监测BPD儿童的短期和长期肾脏结局。
