Renal Functions in Low Birth Weight Children
Renálne funkcie u detí s nízkou pôrodnou hmotnosťou
Rizikové faktory nízkej pôrodnej hmotnosti (LBW) negatívne ovplyvňujú vývojový program organizmu inutero. Formujú sa hypoplastické obličky s menším počtom nefrónov (oligonefropatia), kapilárna denzita v tkaniváchje znížená, cievny endotel má porušenú funkciu. V dôsledku uvedených skutočností sa u detí s nízkoupôrodnouhmotnosťou vmladom dospelom veku častejšie manifestujú pridružené ochorenia (hypertenzia, diabetesmellitus typ 2) prispievajúce k postupnému poklesu obličkových funkcií a k zvýšenej pravdepodobnosti neskoršiehovýskytu chronickej renálnej insuficiencie. Deteriorácii obličkových funkcií predchádza objavenie sa mikroalbuminúrie.
Klíčová slova:
nízka pôrodná hmotnosť, oligonefropatia, endotelová dysfunkcia, pridružené ochorenia, mikroalbuminúria,chronická renálna insuficiencia
Authors:
M. Mráz; Ľ. Podracká
Authors place of work:
Klinika detí a dorastu LF UPJŠ a DFN, Košiceprednostka prof. MUDr. Ľ. Podracká, CSc.
Published in the journal:
Čes-slov Pediat 2003; (10): 653-655.
Category:
Summary
Many potential risk factors or low birth weight (LBW)may negativelymodify the renal developmental programin utero, resulting in congenital oligonephropathy (< 0.3.106 nephrons per kidney). Impaired vasculatory developmentis another consequence of LBW. Low capillary density and endothelial dysfunction are present throughoutthe tissues. Renal functions ofLBW children are limited to early postnatally due to oligonephropathy and nephronstructural and functional immaturity. Since the nephron compensatory hypertrophy, kidney functions in LBWchildren reach the physiological values by early childhood. In contrast, the late consequences of LBW areprognosticaly more serious. Higher incidence of hypertension and type 2 diabetes mellitus (LBW associateddiseases) occurs within the population of LBW patients in early adulthood. The exact pathogenic mechanism ofthis association is not known. Genetic factors, risk factors ofLBW, oligonephropathy, endothelial dysfunction, lowcapillary density and adult risk factors probably play important roles. Associated diseased contribute to thesubsequent decline in renal functions, microalbuminuria may serve as an early predictor of kidney damage.Consequently, the overall incidence of chronic renal failure among LBW children in the adulthood is highercomparing to those born in term.
Key words:
low birth weight, congenital oligonephropathy, endothelial dysfunction, associated diseases,microalbuminuria, chronic renal failure
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2003 Číslo 10
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