Preterm Birth and Kidney Health: From the Womb to the Rest of Life.

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-10-02 DOI:10.3390/children11101213
You-Lin Tain, Chien-Ning Hsu
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Abstract

Chronic kidney disease (CKD) is a widespread condition often resulting from multiple factors, including maternal influences. These risk factors not only heighten the likelihood of developing CKD but increase the risk of a preterm birth. Adverse events during nephrogenesis can disrupt kidney development, leading to a reduced number of nephrons. As survival rates for preterm infants improve, more individuals are living into adulthood, thereby elevating their risk of CKD later in life. This review aims to explore the connections between preterm birth, kidney development, and the increased risk of CKD, while proposing practical solutions for the future through a multidisciplinary approach. We examine human studies linking preterm birth to negative kidney outcomes, summarize animal models demonstrating kidney programming and reduced nephron numbers, and consolidate knowledge on common mechanisms driving kidney programming. Additionally, we discuss factors in the postnatal care environment that may act as secondary insults contributing to CKD risk, such as acute kidney injury (AKI), the use of nephrotoxic drugs, preterm nutrition, and catch-up growth. Finally, we outline recommendations for action, emphasizing the importance of avoiding modifiable risk factors and implementing early CKD screening for children born preterm. Together, we can ensure that advancements in kidney health keep pace with improvements in preterm care.

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早产与肾脏健康:从子宫到生命的其余部分。
慢性肾脏病(CKD)是一种广泛存在的疾病,通常由多种因素造成,其中包括母体的影响。这些风险因素不仅会增加罹患 CKD 的可能性,还会增加早产的风险。肾脏生成过程中的不良事件会破坏肾脏的发育,导致肾小球数量减少。随着早产儿存活率的提高,越来越多的人活到了成年,从而增加了他们日后患上慢性肾脏病的风险。本综述旨在探讨早产、肾脏发育和慢性肾脏病风险增加之间的联系,同时通过多学科方法为未来提出切实可行的解决方案。我们探讨了将早产与肾脏不良后果联系起来的人类研究,总结了证明肾脏发育过程和肾小球数量减少的动物模型,并整合了有关驱动肾脏发育过程的共同机制的知识。此外,我们还讨论了产后护理环境中可能导致慢性肾脏病风险的二次伤害因素,如急性肾损伤 (AKI)、肾毒性药物的使用、早产营养和追赶性生长。最后,我们概述了行动建议,强调了避免可改变的风险因素和对早产儿进行早期慢性肾脏病筛查的重要性。通过共同努力,我们可以确保肾脏健康的进步与早产儿护理的改善同步。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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