Proteinuria and progressive renal disease: birth weight and microalbuminuria.

BACKGROUND

Microalbuminuria and nephropathy in diabetic subjects has been linked to low birth weight or short stature in adulthood. We have explored the relationship of foetal growth and intrauterine starvation with microalbuminuria in non-diabetic subjects.

METHODS

Albumin excretion rate was measured in an overnight sample in 236 men and women in Preston whose birth anthropometry had been recorded at the local maternity hospital. Albumin excretion rate was also measured in a 2-h and overnight sample in 98 subjects exposed to intrauterine maternal starvation during the Siege of Leningrad as well as in 124 subjects exposed in infancy and 62 born concurrently outside the Siege limits.

RESULTS

In 236 men and women aged 46-54 years in Preston, 11 had microalbuminuria on an overnight urine collection. There were trends for these subjects to have lower birth weight (105.8 oz vs. 112.9 oz, P = 0.20) and lower ponderal index at birth (12.3 oz/in3 x 1000 vs. 13.4 oz/in3 x 1000, P = 0.09) than those who were normoalbuminuric. The albumin excretion rate of the subjects exposed in utero to maternal starvation (daytime sample 5.2 x/divided by 2.8 micrograms.min-1; overnight sample 2.9 x/divided by 2.5 micrograms.min-1) was not significantly different from those of the subjects exposed in infancy (5.5 x/divided by 2.7 micrograms.min-1 and 3.3 x/divided by 2.5 micrograms.min-1, respectively) or from those who were unexposed (5.1 x/divided by 3.0 micrograms.min-1 and 3.2 x/divided by 2.2 micrograms x min-1, respectively), (P = 0.99 for daytime and P = 0.73 for overnight rates controlling for sex, BMI, and systolic blood pressure).

CONCLUSIONS

Consistent relationships of short stature with microalbuminuria and nephropathy in non-diabetic and diabetic subjects might suggest that more subtle anthropometric indices could relate to low nephron number at birth, or that postnatal or genetic influences could underlie the observed link.