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

Megan R. Sutherland, Mark D. Chatfield, Belinda Davison, Danica Vojisavljevic, Alison L. Kent, Wendy E. Hoy, Gurmeet R. Singh, Mary Jane Black

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1205-1216
Number of pages11
JournalKidney International
Volume96
Issue number5
Early online date13 Aug 2019
DOIs
Publication statusPublished - Nov 2019

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Premature Infants
Kidney
Premature Birth
Chronic Renal Insufficiency
Urine
Anti-Bacterial Agents
Cystatin C
Pregnancy
Birth Weight
Gestational Age
Observational Studies
Albumins
Creatinine
Cohort Studies
Smoking
Sodium
Mothers
Wounds and Injuries
Serum

Cite this

Sutherland, M. R., Chatfield, M. D., Davison, B., Vojisavljevic, D., Kent, A. L., Hoy, W. E., ... Black, M. J. (2019). Renal dysfunction is already evident within the first month of life in Australian Indigenous infants born preterm. Kidney International, 96(5), 1205-1216. https://doi.org/10.1016/j.kint.2019.07.015
Sutherland, Megan R. ; Chatfield, Mark D. ; Davison, Belinda ; Vojisavljevic, Danica ; Kent, Alison L. ; Hoy, Wendy E. ; Singh, Gurmeet R. ; Black, Mary Jane. / Renal dysfunction is already evident within the first month of life in Australian Indigenous infants born preterm. In: Kidney International. 2019 ; Vol. 96, No. 5. pp. 1205-1216.
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abstract = "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.",
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Sutherland, MR, Chatfield, MD, Davison, B, Vojisavljevic, D, Kent, AL, Hoy, WE, Singh, GR & Black, MJ 2019, 'Renal dysfunction is already evident within the first month of life in Australian Indigenous infants born preterm', Kidney International, vol. 96, no. 5, pp. 1205-1216. https://doi.org/10.1016/j.kint.2019.07.015

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; Kent, Alison L.; Hoy, Wendy E.; Singh, Gurmeet R.; Black, Mary Jane.

In: Kidney International, Vol. 96, No. 5, 11.2019, p. 1205-1216.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Singh, Gurmeet R.

AU - Black, Mary Jane

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KW - kidney development

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