抄録
Introduction: Former extreme low birth weight (ELBW, <1000g) infants have a mean estimated GFR for Cystatin C (eGFRcysC) that is one SD lower compared to term born controls at young adolescence and a relevant portion (20-25 %) has an eGFRcysC <90 ml/min/1.73m2 (1,2). We explored this dataset on links between perinatal steroid exposure and renal outcome.
Methods: The PREMATCH study generated data on renal function [renal length, estimated glomerular filtration rate based on cystatin C (eGFRcysC)] in 93 former ELBW cases at the age of 11 years. In this post hoc analysis, we linked markers of renal function in young adolescence in former ELBW cases to perinatal steroid exposure. Bivariate analysis (Mann-Whitney U) was used.
Results: Prenatal steroids were provided to 84%, postnatal steroids to 52% of ELBW cases. There was no significant difference in median eGFRCysC estimates between cases exposed or not exposed to steroids, neither prenatal (96.8 vs 100.3,p=0.92) nor postnatal (97.9 vs 94.5,p=0.73) ml/min/1.73m2. We neither found significant associations between perinatal steroid exposure and renal length.
Conclusions: perinatal steroid exposure was not associated with renal impairment at adolescence. Larger studies are needed to explore associations of perinatal factors with renal impairment in former ELBW cases. This matters, since relates to an increased risk for hypertension, cardiovascular events and renal disease in later life, while identification of risk factors holds the promise of secondary prevention.
Ref: Raaijmakers et al, Arch Dis Child doi: 10.1136/archdischild-2017-312922; Raaijmakers et al, Hypertension 2017;69:443-9
Supported by the agency for innovation by Science and Technology in Flanders (IWT) SAFEPEDRUG project (IWT/SBO 130033).
