Role of foetal kidney size on kidney function in childhood: the born in bradford cohort renal study

• Published in: BMC nephrology 2023-02, Vol.24 (1), p.41-11, Article 41
• Main Authors: Ziauddeen, Nida, Jeffrey, Robin F, Waiblinger, Dagmar, Fraser, Simon Ds, Alwan, Nisreen A, Yuen, Ho M, Azad, Rafaq, Mason, Dan, Wright, John, Coward, Richard Jm, Roderick, Paul J
• Format: Article
• Language: English
• Subjects: Albuminuria; Albuminuria - urine; Biomarkers; Birth weight; Birth weight, Low; Blood pressure; Body mass index; Cardiovascular diseases; Child; Childhood; Children; Children & youth; Chronic kidney failure; Cohort analysis; Complications and side effects; Creatinine; Cystatin C; Epidermal growth factor receptors; Ethnicity; Fetus; foetal development; Gestational age; Gestational diabetes; Glomerular filtration rate; Glomerular Filtration Rate - physiology; Growth; Health aspects; Humans; Hypertension; Infant, Newborn; Kidney - anatomy & histology; Kidney - physiology; Kidney diseases; Kidney Function Tests; kidney volume; Kidneys; Laboratories; Nephrology; Organ Size; Pregnancy; Prevention; Proteins; Puberty; Reference materials; Risk factors; Sensitivity analysis; Ultrasonic imaging; Urine; Vitamin A; Womens health
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-023-03077-6

Foetal and early childhood development contributes to the risk of adult non-communicable diseases such as hypertension and cardiovascular disease. We aimed to investigate whether kidney size at birth is associated with markers of kidney function at 7-11 years. Foetal kidney dimensions were measured using ultrasound scans at 34 weeks gestation and used to derive kidney volume (cm ) in 1802 participants in the Born in Bradford (BiB) birth cohort. Blood and urine samples were taken from those who participated in the BiB follow-up at 7-11 years (n = 630) and analysed for serum creatinine, cystatin C, urea, and urinary albumin to creatinine ratio (ACR), protein to creatinine ratio (PCR) and retinol binding protein (RBP). Estimated glomerular filtration rate (eGFR) was calculated using Schwartz creatinine only and combined with cystatin C, and cystatin C only Zappitelli and Filler equations. Linear regression was used to examine the association between foetal kidney volume and eGFR, ACR, PCR and blood pressure, unadjusted and adjusted for confounders. Kidney volume was positively associated in adjusted models with eGFR calculated using Schwartz combined (0.64 ml/min diff per unit increase in volume, 95% CI 0.25 to 1.02), Zappitelli (0.79, 95% CI 0.38 to 1.20) and Filler (2.84, 95% CI 1.40 to 4.28). There was an association with the presence of albuminuria but not with its level, or with other urinary markers or with blood pressure. Foetal kidney volume was associated with small increases in eGFR in mid-childhood. Longitudinal follow-up to investigate the relationship between kidney volume and markers of kidney function as children go through puberty is required.