Reduced renal length and volume 20 years after very preterm birth

Abstract

Intrauterine growth retardation is presumed to be associated with decreased renal size and impaired renal function as a result of stunted kidney development and nephron deficit. To study whether very preterm birth also affects renal size at young adulthood, we sonographically measured bipolar kidney length and volume in 51 very premature individuals (<32 weeks of gestation), either small (SGA) or appropriate (AGA) for gestational age (22 SGA and 29 AGA), and 30 full-term controls 20 years after birth. Relative kidney length and volume were calculated. Both absolute and relative left kidney length and volume were significantly lower in SGA and AGA individuals, notably in women. Renal size did not differ between SGA and AGA individuals. In 70% of controls, the left kidney was larger than the right one compared with 40.9% in SGA [relative risk (RR) 1.7; 95% confidence interval (CI) 1.0-3.0] and 48.3% in AGA (RR 1.5; 95% CI 0.9-2.3) individuals. Renal structural anomalies were present in eight prematurely born participants only. Our data suggest that kidney growth is stunted after preterm birth, especially on the left side, and in the female gender.

Fig. 1

Mean kidney volume in right and left kidney in SGA, AGA and Controls

Fig. 2

Total kidney volume in the three study groups

Fig. 3

Relation between body surface area and total kidney volume (a) and body height and total kidney length (b)

Fig. 4

Body surface area (m²) plotted to left (a) and right (b) kidney volume. Body height (cm) plotted to left (c) and right (d) bipolar kidney length