Increased Albuminuria in 4-Year-Old Preterm-Born Children with Normal Height

Objective To determine risk factors for high blood pressure (BP), increased markers of glomerulosclerosis, and tubular dysfunction in 4-year-old preterm-born children. Study design The study group was a longitudinal cohort of 119 children with BP, albuminuria, and beta 2 microglobulin measurements obtained during the neonatal period and at age 4 years. Results Systolic BP was >95th percentile in 15 (12.6%) of the children at age 4 years and lower in those born small for gestational age compared with those born appropriate for gestational age. Preterm-born 4-year-olds with height <-1 SD had lower systolic and diastolic BP, and 14.4% of the 4-year-olds had albuminuria. Albuminuria was less prevalent in the 4-year-olds with height <-1 SD than in those with height >=-1 SD (6.8% vs 19.3%; P = .04). Mean albuminuria level was 1.0 +/- 0.7 mg/mmol in 4-year-olds with height <-1 SD and 1.4 +/- 1.3 mg/mmol in those with height >=-1 SD. In multivariate analysis, albuminuria level was increased by 0.4 +/- 0.2 mg/mmol in preterm-born children with normal height at age 4, and by 0.5 +/- 0.2 mg/mmol in females, after adjustment for gestational age, sex, neonatal morbidity, and intrauterine growth restriction. These results were unchanged after adjustment for body mass index. Conclusion Normal height at age 4 years may be associated with an increased risk for glomerulosclerosis in preterm-born children. (J Pediatr 2012;160:923-8).