Brennan Sonja, Rudd Donna, Watson David, Kandasamy Yogavijayan
Maternal Fetal Medicine and Ultrasound, Townsville University Hospital, Douglas, Townsville, Australia.
Division of Tropical Health and Medicine, James Cook University, Townsville, Australia.
J Nephrol. 2024 Dec;37(9):2531-2539. doi: 10.1007/s40620-024-02141-0. Epub 2024 Dec 6.
The significance of intergenerational impacts on fetal and infant kidney development and function remains to be fully understood. This is particularly relevant for certain populations, for example the Indigenous Australians since their risk of developing chronic kidney disease (CKD) is twice that of non-Indigenous Australians. The aim of this study was to assess the impact of maternal health and kidney size and function on infant kidney development.
This study was open to all pregnant women receiving antenatal care at Townsville University Hospital, Australia. It presents data from a larger, ongoing prospective, longitudinal cohort study which commenced August 2019, involving mother-infant dyads. This manuscript reports on term mother-infants' dyads from singleton pregnancies. Ultrasound was used to measure renal parenchymal thickness, a surrogate for nephron number, of the mother and their newborn. Kidney function was assessed using serum cystatin C and creatinine.
Analysis was conducted on 80 mother-infant dyads, 17 Indigenous and 63 non-Indigenous. Multivariate regression modeling showed maternal renal parenchymal thickness (ß = 0.31, p = 0.004), smoking (ß = - 0.70, p = 0.022) and maternal serum cystatin C (ß = - 0.34, p = 0.014) significantly predicted newborn renal parenchymal thickness. No significant differences were found between the maternal and newborn renal parenchymal thickness and function between Indigenous and non-Indigenous participants.
Our study suggests that maternal kidney size and function has a significant intergenerational effect on kidney development of their infants. Newborn renal parenchymal thickness was positively associated with maternal renal parenchymal thickness and negatively associated with smoking and maternal serum cystatin C.
代际影响对胎儿及婴儿肾脏发育和功能的重要性仍有待充分了解。这对于某些人群尤为重要，例如澳大利亚原住民，因为他们患慢性肾脏病（CKD）的风险是非原住民澳大利亚人的两倍。本研究的目的是评估母亲的健康状况、肾脏大小和功能对婴儿肾脏发育的影响。
本研究对在澳大利亚汤斯维尔大学医院接受产前护理的所有孕妇开放。它展示了一项规模更大、正在进行的前瞻性纵向队列研究的数据，该研究于2019年8月开始，涉及母婴二元组。本手稿报告了单胎妊娠足月母婴二元组的情况。使用超声测量母亲及其新生儿的肾实质厚度，作为肾单位数量的替代指标。使用血清胱抑素C和肌酐评估肾功能。
对80对母婴二元组进行了分析，其中17对为原住民，63对为非原住民。多变量回归模型显示，母亲的肾实质厚度（β = 0.31，p = 0.004）、吸烟（β = -0.70，p = 0.022）和母亲血清胱抑素C（β = -0.34，p = 0.014）显著预测新生儿肾实质厚度。原住民和非原住民参与者之间在母亲和新生儿的肾实质厚度及功能方面未发现显著差异。
我们的研究表明，母亲的肾脏大小和功能对其婴儿的肾脏发育具有显著的代际影响。新生儿肾实质厚度与母亲肾实质厚度呈正相关，与吸烟和母亲血清胱抑素C呈负相关。
