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1387 Impact of Perinatal Nutrition on Kidney Function at Five Years in Very Low Bieth-Weight Children
  1. R Vieux1,2,
  2. S Galu1,
  3. F Guillemin2,
  4. JM Hascoet1
  1. 1Department of Neonatology, Maternite Regionale Universitaire, Nancy Cedex
  2. 2EA4360 APEMAC, Lorraine University, Nancy, France

Abstract

Aim To determine the impact of perinatal factors on renal function in five year-old preterm-born children.

Material and Methods Prospective longitudinal study of preterm-born children from birth to five years of age, and five year-old full-term controls. Renal function measured in the neonatal period and at five years.

Primary outcome was renal function at five years: blood pressure (BP), estimated glomerular filtration rate (eGFR), albuminuria. Multivariate analysis was performed with multiple linear regression models.

Results 168 children included aged 5.1±0.1 years. 133 preterm-born children, born: 29.2±1.4 weeks gestation; 35 full-term children aged five.

Systolic BP (sBP) was 97.5±7.1 mmHg in preterm-born children versus 92.2±8.1 mmHg in full-term controls, p=0.0001. In preterm-born children, sBP increased by (β±σ): 2.2±1.0 mmHg for each gram/kg increase in proteins/day on day 28, and decreased by –3.0±1.4 in case of bronchopulmonary dysplasia, after adjustment on gender and height at five years.

eGFR was 176.3±37.1 mL/min/1.73m² at five in preterm-born children. It was significantly decreased when children had presented hyaline membrane disease or necrotising enterocolitis, respectively (β±σ): –17.6±6.7 and –25.7±10.4 mL/min/1.73m². eGFR at five was not associated with neonatal nutrition.

14.4% preterm-born children had an albumin ratio >2 mg/mmol vs. 11.1% full-terms, p=0.7.

Renal volume, absolute or relative, at five years was negatively correlated to protein intakes from day 14 onwards in the neonatal period: R= –0.69, p=0.006.

Conclusion Protein intakes in the neonatal period are associated to an increased BP and decreased renal volume in five year-old preterm-born children.

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