Fagundes Pasini Laís, Fauth de Araújo Breno, Girotto de Aguiar Lucas, da Silva Selistre Luciano, Carla de Souza Vandréa
Universidade de Caxias do Sul, Programa de Pós-Graduação em Ciências da Saúde, Caxias do Sul, RS, Brazil; Universidade de Caxias do Sul, Área do Conhecimento de Ciências da Vida, Caxias do Sul, RS, Brazil.
Hospital Geral de Caxias do Sul, Caxias do Sul, RS, Brazil.
J Pediatr (Rio J). 2025 May-Jun;101(3):400-406. doi: 10.1016/j.jped.2025.01.002. Epub 2025 Feb 28.
To identify factors, particularly neonatal acute kidney injury, associated with an increased risk of developing chronic kidney disease (CKD) within the first 10 years of life in children with a history of prematurity and very low birth weight (VLBW).
This nested case-control study was conducted on VLBW infants (> 500 g and < 1.500 g) born between 2012 and 2022. The population (n = 119) included children who developed CKD (n = 55) and controls with normal findings (n = 64). CKD was defined by abnormal blood pressure, reduced glomerular filtration rate, or elevated urinary albumin excretion. Data on neonatal and maternal factors were analyzed using logistic regression to identify predictors of CKD.
Of the 267 eligible children 119 were included, with a median age of 32 months, and median gestational age and birth weight of 30 weeks and 1170 g, respectively. Children with CKD had lower birth weight Z-scores (-1.06 vs. -0.89), a higher occurrence of extrauterine growth restriction (EUGR) (72 % vs. 51 %), and an increased likelihood of maternal preeclampsia exposure. Maternal preeclampsia was identified as an independent predictor of CKD, associated with a 5 % increase in the odds of developing the condition (OR 1.05, 95 % CI 1.01-1.66).
Maternal preeclampsia was associated with CKD in children with a history of VLBW. This finding highlights the importance of long-term follow-up and early identification of at-risk individuals.
确定与早产和极低出生体重（VLBW）病史儿童在生命最初10年内发生慢性肾脏病（CKD）风险增加相关的因素，尤其是新生儿急性肾损伤。
本巢式病例对照研究针对2012年至2022年间出生的VLBW婴儿（>500g且<1500g）开展。研究人群（n = 119）包括发生CKD的儿童（n = 55）和检查结果正常的对照组（n = 64）。CKD通过血压异常、肾小球滤过率降低或尿白蛋白排泄增加来定义。使用逻辑回归分析新生儿和母亲因素的数据，以确定CKD的预测因素。
267名符合条件的儿童中，119名被纳入研究，中位年龄为32个月，中位胎龄和出生体重分别为30周和1170g。患有CKD的儿童出生体重Z评分较低（-1.06对-0.89），宫外生长受限（EUGR）发生率较高（72%对51%），母亲子痫前期暴露的可能性增加。母亲子痫前期被确定为CKD的独立预测因素，发生该疾病的几率增加5%（比值比1.05，95%置信区间1.01 - 1.66）。
母亲子痫前期与有VLBW病史儿童的CKD有关。这一发现凸显了长期随访和早期识别高危个体的重要性。
