An Individualized Approach to Kidney Disease Screening in Children With a History of Preterm Birth
Year: 2022
Type: article
Abstract: Well-child Bright Futures screenings provide considerable benefits for child health and disease prevention; however, the benchmarks and screening for the many children with medical comorbidities are less well defined.With advancements in pediatric medicine, more children are living well with chronic diseases such as asthma, obesity, and hypertension.For these children, a more individualized approach to screening for comorbidities is needed.Many studies indicate that biological aging is accelerated among childhood survivors of critical illness and disease.[1][2][3][4] We suggest that a risk-stratification framework for chronic disease, based on early life and childhood exposures, will enhance early chronic disease recognition and improve long-term health outcomes in children.One of the most prevalent risk factors for long-term morbidity in children that pediatricians encounter is preterm birth.While an individualized approach to screening for comorbidities would benefit all children with a chronic diagnosis or a history of prolonged hospital course, the specific example on which we focus on in this commentary is the relationship between preterm birth and chronic kidney disease (CKD). Preterm Birth and CKDPreterm birth occurs in 1 in 10 live births in the United States.Compared with infants born at term, preterm infants are twice as likely to develop CKD over the life course.5 Sixty percent of nephrogenesis occurs in the second and third trimester.Birth before 37 weeks results in lifelong decreased nephron number.As a result, there is decreased kidney reserve and increased susceptibility to insults, such as acute kidney injury (AKI), further
Source: Clinical Pediatrics
Institution: University of North Carolina at Chapel Hill
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1608788433, G2785581091
OpenAlex ID: W4307093467