The association of low birthweight and prematurity on outcomes in children and adults with nephrotic syndrome-a NEPTUNE cohort study.
Decline in kidney function
FSGS
Minimal change disease
Nephrotic syndrome
Prematurity
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
06
07
2022
accepted:
22
12
2022
revised:
22
11
2022
medline:
31
8
2023
pubmed:
4
5
2023
entrez:
4
5
2023
Statut:
ppublish
Résumé
In single-center studies, both preterm birth and low birth weight (LBW) are associated with worse outcomes in childhood nephrotic syndrome. Using the Nephrotic Syndrome Study Network (NEPTUNE) observational cohort, we tested the hypothesis that in patients with nephrotic syndrome, hypertension, proteinuria status, and disease progression would be more prevalent and more severe in subjects with LBW and prematurity singly or in combination (LBW/prematurity). Three hundred fifty-nine adults and children with focal segmental glomerulosclerosis (FSGS) or minimal change disease (MCD) and available birth history were included. Estimated glomerular filtration rate (eGFR) decline and remission status were primary outcomes, and secondary outcomes were kidney histopathology, kidney gene expression, and urinary biomarkers. Logistic regression was used to identify associations with LBW/prematurity and these outcomes. We did not find an association between LBW/prematurity and remission of proteinuria. However, LBW/prematurity was associated with greater decline in eGFR. This decline in eGFR was partially explained by the association of LBW/prematurity with APOL1 high-risk alleles, but the association remained after adjustment. There were no differences in kidney histopathology or gene expression in the LBW/prematurity group compared to normal birth weight/term birth. LBW and premature babies who develop nephrotic syndrome have a more rapid decline in kidney function. We did not identify clinical or laboratory features that distinguished the groups. Additional studies in larger groups are needed to fully ascertain the effects of (LBW) and prematurity alone or in combination on kidney function in the setting of nephrotic syndrome.
Sections du résumé
BACKGROUND
In single-center studies, both preterm birth and low birth weight (LBW) are associated with worse outcomes in childhood nephrotic syndrome. Using the Nephrotic Syndrome Study Network (NEPTUNE) observational cohort, we tested the hypothesis that in patients with nephrotic syndrome, hypertension, proteinuria status, and disease progression would be more prevalent and more severe in subjects with LBW and prematurity singly or in combination (LBW/prematurity).
METHODS
Three hundred fifty-nine adults and children with focal segmental glomerulosclerosis (FSGS) or minimal change disease (MCD) and available birth history were included. Estimated glomerular filtration rate (eGFR) decline and remission status were primary outcomes, and secondary outcomes were kidney histopathology, kidney gene expression, and urinary biomarkers. Logistic regression was used to identify associations with LBW/prematurity and these outcomes.
RESULTS
We did not find an association between LBW/prematurity and remission of proteinuria. However, LBW/prematurity was associated with greater decline in eGFR. This decline in eGFR was partially explained by the association of LBW/prematurity with APOL1 high-risk alleles, but the association remained after adjustment. There were no differences in kidney histopathology or gene expression in the LBW/prematurity group compared to normal birth weight/term birth.
CONCLUSION
LBW and premature babies who develop nephrotic syndrome have a more rapid decline in kidney function. We did not identify clinical or laboratory features that distinguished the groups. Additional studies in larger groups are needed to fully ascertain the effects of (LBW) and prematurity alone or in combination on kidney function in the setting of nephrotic syndrome.
Identifiants
pubmed: 37140708
doi: 10.1007/s00467-023-05876-3
pii: 10.1007/s00467-023-05876-3
doi:
Substances chimiques
APOL1 protein, human
0
Apolipoprotein L1
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3297-3308Subventions
Organisme : NIDDK NIH HHS
ID : U54 DK083912
Pays : United States
Investigateurs
S Massengill
(S)
L Lo
(L)
K Dell
(K)
J Sedor
(J)
B Martin
(B)
K Lemley
(K)
C Fajardo
(C)
S Sharma
(S)
T Srivastava
(T)
K Markus
(K)
C Sethna
(C)
S Vento
(S)
P Canetta
(P)
A Pradhan
(A)
R Gbadegesin
(R)
O Olabisi
(O)
L Greenbaum
(L)
C S Wang
(CS)
E Yun
(E)
S Adler
(S)
J LaPage
(J)
A Amarah
(A)
M Itteera
(M)
M Atkinson
(M)
M Williams
(M)
F Fervenza
(F)
M Hogan
(M)
J Lieske
(J)
D Selewski
(D)
C Conley
(C)
F Kaskel
(F)
M Ross
(M)
P Flynn
(P)
J Kopp
(J)
L Malaga-Dieguez
(L)
O Zhdanova
(O)
L J Pehrson
(LJ)
S Almaani
(S)
C Price
(C)
R Lafayette
(R)
S Dave
(S)
I Lee
(I)
Z Pfeiffer
(Z)
S Shah
(S)
A Deslandes
(A)
H Reich
(H)
M Hladunewich
(M)
P Ling
(P)
M Romano
(M)
P Brakeman
(P)
A Podoll
(A)
N Rogers
(N)
E McCarthy
(E)
E Landry
(E)
A Fornoni
(A)
C Bidot
(C)
M Kretzler
(M)
D Gipson
(D)
A Williams
(A)
M Stelzer
(M)
P Nachman
(P)
M Rheault
(M)
S Rajala
(S)
V Derebail
(V)
K Gibson
(K)
A Froment
(A)
F Ochoa-Toro
(F)
L Holzman
(L)
K Meyers
(K)
K Kallem
(K)
A Edwards
(A)
K Sharma
(K)
K Sambandam
(K)
E Robles
(E)
M Turk
(M)
A Jefferson
(A)
S Hingorani
(S)
K Tuttle
(K)
L Manahan
(L)
E Pao
(E)
K Kuykendall
(K)
J J Lin
(JJ)
E Cody
(E)
Informations de copyright
© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.
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