Renal dysfunction is already evident within the first month of life in Australian Indigenous infants born preterm

Sutherland, Megan R., Chatfield, Mark D., Davison, Belinda, Vojisavljevic, Danica, Alison, Kent L., Hoy, Wendy E., Singh, Gurmeet R., and Black, Mary Jane (2019) Renal dysfunction is already evident within the first month of life in Australian Indigenous infants born preterm. Kidney International, 96 (5). pp. 1205-1216.

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Antecedents of the high rates of chronic kidney disease in Australian Indigenous peoples may originate early in life. Fourteen percent of Australian Indigenous infants are born preterm (under 37 weeks gestation) and, therefore, at risk. Here, our observational cohort study sought to determine the impact of preterm birth on renal function in Australian Indigenous and non-Indigenous infants. Renal function was assessed between 4-29 days postnatally in 60 Indigenous and 42 non-Indigenous infants born at 24-36 weeks gestation. Indigenous ethnicity was associated with impaired renal function, with significantly higher serum creatinine (geometric mean ratio (GMR) 1.15 [1.06, 1.25]), fractional excretion of sodium (GMR 1.21 [1.04, 1.39]), and urine albumin (GMR 1.57 [1.05, 2.34]), β-2 microglobulin (GMR 1.82 [1.11, 2.98]) and cystatin C (GMR 3.27 [1.54, 6.95]) when controlling for gestational/postnatal age, sex and birth weight Z-score. Renal injury, as indicated by high urine neutrophil gelatinase-associated lipocalin levels, was associated with maternal smoking and postnatal antibiotic exposure. Indigenous infants appeared to be most susceptible to the adverse impact of antibiotics. These findings show that preterm Australian Indigenous infants are highly vulnerable to renal dysfunction. Preterm birth may contribute to their increased risk of chronic kidney disease. Thus, we recommended that renal function should be closely monitored life-long in Indigenous children born preterm.

Item ID: 65278
Item Type: Article (Research - C1)
ISSN: 1523-1755
Keywords: Chronic kidney disease, Indigenous, Kidney development, neonate, nephrotoxin, preterm birth
Copyright Information: © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
Funders: National Health and Medical Research Council of Australia (NHMRC), Capstone Editing
Projects and Grants: NHMRC 1011136, NHMRC CJ Martin Fellowship
Date Deposited: 23 Dec 2020 03:44
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320214 Nephrology and urology @ 100%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 100%
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