Renal consequences of preterm birth

dc.contributor.authorStritzke, Amelie
dc.contributor.authorThomas, Sumesh
dc.contributor.authorAmin, Harish
dc.contributor.authorFusch, Christoph
dc.contributor.authorLodha, Abhay
dc.date.accessioned2018-11-07T17:10:30Z
dc.date.available2018-11-07T17:10:30Z
dc.date.issued2017-01-18
dc.date.updated2018-11-07T17:10:30Z
dc.description.abstractAbstract Background The developmental origin of health and disease concept identifies the brain, cardiovascular, liver, and kidney systems as targets of fetal adverse programming with adult consequences. As the limits of viability in premature infants have been pushed to lower gestational ages, the long-term impact of prematurity on kidneys still remains a significant burden during hospital stay and beyond. Objectives The purpose of this study is to summarize available evidence, mechanisms, and short- and long-term renal consequences of prematurity and identify nephroprotective strategies and areas of uncertainty. Results Kidney size and nephron number are known to be reduced in surviving premature infants due to disruption of organogenesis at a crucial developmental time point. Inflammation, hyperoxia, and antiangiogenic factors play a role in epigenetic conditioning with potential life-long consequences. Additional kidney injury from hypoperfusion and nephrotoxicity results in structural and functional changes over time which are often unnoticed. Nephropathy of prematurity and acute kidney injury confound glomerular and tubular maturation of preterm kidneys. Kidney protective strategies may ameliorate growth failure and suboptimal neurodevelopmental outcomes in the short term. In later life, subclinical chronic renal disease may progress, even in asymptomatic survivors. Conclusion Awareness of renal implications of therapeutic interventions and renal conservation efforts may lead to a variety of short and long-term benefits. Adequate monitoring and supplementation of microelement losses, gathering improved data on renal handling, and exploration of new avenues such as reliable markers of injury and new therapeutic strategies in contemporary populations, as well as long-term follow-up of renal function, is warranted.
dc.identifier.citationMolecular and Cellular Pediatrics. 2017 Jan 18;4(1):2
dc.identifier.doihttps://doi.org/10.1186/s40348-016-0068-0
dc.identifier.urihttp://hdl.handle.net/1880/109132
dc.identifier.urihttps://doi.org/10.11575/PRISM/45183
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.titleRenal consequences of preterm birth
dc.typeJournal Article
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