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Tracking and determinants of kidney size from fetal life until the age of 2 years: the Generation R Study.
Am J Kidney Dis 2009; 53(2):248-58AJ

Abstract

BACKGROUND

An adverse fetal environment may lead to smaller kidneys and subsequently kidney disease and hypertension in adulthood. The aims of this study are to examine whether kidney size tracks from fetal life to childhood and whether maternal and fetal characteristics are associated with kidney size at the age of 2 years.

STUDY DESIGN

Prospective cohort study from fetal life onward.

SETTING & PARTICIPANTS

The study was conducted in a group of 688 infants in Rotterdam, The Netherlands. Entry criteria were singleton, noncomplicated pregnancies, and Dutch ethnicity.

PREDICTORS

The maternal characteristics age, height, and prepregnancy weight were measured in early pregnancy. Fetal growth, head circumference, abdominal circumference, femur length and estimated fetal weight, and placental characteristics were assessed in the second and third trimesters.

OUTCOMES & MEASUREMENTS

Kidney size, defined as length, width, depth, and volume, was measured in the third trimester of pregnancy and at postnatal ages 6 and 24 months.

RESULTS

Overall median gestational age was 40.3 weeks (95% range, 36.0 to 42.3 weeks), and mean birth weight was 3,536 +/- 524 (SD) g. Children tended to remain in the lowest and highest quartiles of kidney volume from the third trimester to the age of 2 years (odds ratio, 2.05; 95% confidence interval, 1.38 to 3.06; odds ratio, 3.29; 95% confidence interval, 2.22 to 4.87, respectively). Maternal height and prepregnancy weight were associated positively with kidney volume at the age of 2 years. Third-trimester fetal head circumference, abdominal circumference, and estimated weight and postnatal length were associated positively with kidney volume at the age of 2 years. Preferential fetal blood flow to the brain was associated with smaller kidneys.

LIMITATIONS

Kidney measurements successfully performed in only 86% of children.

CONCLUSIONS

Small kidney size in fetal life tends to persist in early childhood. Maternal anthropometrics and fetal biometrics and blood flow patterns are associated with kidney size in childhood. Follow-up studies are needed to examine whether these variations in kidney size are related to kidney function and blood pressure in later life.

Authors+Show Affiliations

The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18848377

Citation

Geelhoed, J J Miranda, et al. "Tracking and Determinants of Kidney Size From Fetal Life Until the Age of 2 Years: the Generation R Study." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 53, no. 2, 2009, pp. 248-58.
Geelhoed JJ, Verburg BO, Nauta J, et al. Tracking and determinants of kidney size from fetal life until the age of 2 years: the Generation R Study. Am J Kidney Dis. 2009;53(2):248-58.
Geelhoed, J. J., Verburg, B. O., Nauta, J., Lequin, M., Hofman, A., Moll, H. A., ... Jaddoe, V. W. (2009). Tracking and determinants of kidney size from fetal life until the age of 2 years: the Generation R Study. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 53(2), pp. 248-58. doi:10.1053/j.ajkd.2008.07.030.
Geelhoed JJ, et al. Tracking and Determinants of Kidney Size From Fetal Life Until the Age of 2 Years: the Generation R Study. Am J Kidney Dis. 2009;53(2):248-58. PubMed PMID: 18848377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tracking and determinants of kidney size from fetal life until the age of 2 years: the Generation R Study. AU - Geelhoed,J J Miranda, AU - Verburg,Bero O, AU - Nauta,Jeroen, AU - Lequin,Maarten, AU - Hofman,Albert, AU - Moll,Henriëtte A, AU - Witteman,Jacqueline C M, AU - van der Heijden,Albertus J, AU - Steegers,Eric A P, AU - Jaddoe,Vincent W V, Y1 - 2008/10/10/ PY - 2007/03/04/received PY - 2008/07/15/accepted PY - 2008/10/14/pubmed PY - 2009/2/12/medline PY - 2008/10/14/entrez SP - 248 EP - 58 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 53 IS - 2 N2 - BACKGROUND: An adverse fetal environment may lead to smaller kidneys and subsequently kidney disease and hypertension in adulthood. The aims of this study are to examine whether kidney size tracks from fetal life to childhood and whether maternal and fetal characteristics are associated with kidney size at the age of 2 years. STUDY DESIGN: Prospective cohort study from fetal life onward. SETTING & PARTICIPANTS: The study was conducted in a group of 688 infants in Rotterdam, The Netherlands. Entry criteria were singleton, noncomplicated pregnancies, and Dutch ethnicity. PREDICTORS: The maternal characteristics age, height, and prepregnancy weight were measured in early pregnancy. Fetal growth, head circumference, abdominal circumference, femur length and estimated fetal weight, and placental characteristics were assessed in the second and third trimesters. OUTCOMES & MEASUREMENTS: Kidney size, defined as length, width, depth, and volume, was measured in the third trimester of pregnancy and at postnatal ages 6 and 24 months. RESULTS: Overall median gestational age was 40.3 weeks (95% range, 36.0 to 42.3 weeks), and mean birth weight was 3,536 +/- 524 (SD) g. Children tended to remain in the lowest and highest quartiles of kidney volume from the third trimester to the age of 2 years (odds ratio, 2.05; 95% confidence interval, 1.38 to 3.06; odds ratio, 3.29; 95% confidence interval, 2.22 to 4.87, respectively). Maternal height and prepregnancy weight were associated positively with kidney volume at the age of 2 years. Third-trimester fetal head circumference, abdominal circumference, and estimated weight and postnatal length were associated positively with kidney volume at the age of 2 years. Preferential fetal blood flow to the brain was associated with smaller kidneys. LIMITATIONS: Kidney measurements successfully performed in only 86% of children. CONCLUSIONS: Small kidney size in fetal life tends to persist in early childhood. Maternal anthropometrics and fetal biometrics and blood flow patterns are associated with kidney size in childhood. Follow-up studies are needed to examine whether these variations in kidney size are related to kidney function and blood pressure in later life. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/18848377/Tracking_and_determinants_of_kidney_size_from_fetal_life_until_the_age_of_2_years:_the_Generation_R_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(08)01228-6 DB - PRIME DP - Unbound Medicine ER -