Keijzer-Veen MG et al. (2005) Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 16: 2762–2768

Intrauterine growth retardation has been linked to the development of smaller kidneys and might be a risk factor for renal disease in adulthood. To explore this issue, Keijzer-Veen and colleagues have carried out a prospective, follow-up study of glomerular filtration rate and microalbuminuria in young adults who were born very prematurely.

The study included 422 individuals aged 19 years, born at a gestational age of <32 weeks with a mean birth weight of 1.3 kg. All were survivors of the Project on Prematures and Small for Gestational Age Infants (POPS) cohort, recruited in the Netherlands in 1983. The extent of intrauterine growth retardation was assessed by adjusting birth weight for gestational age. Participants were then defined as 'small for gestational age' (SGA) or 'appropriate for gestational age' (AGA).

Although renal function was normal in all participants at age 19 years, associations were found between intrauterine growth retardation and unfavorable renal parameters. Mean glomerular filtration rate, measured using both the Cockcroft–Gault equation and the simplified MDRD EQUATION, was lower in the SGA group than in the AGA group. In addition, the prevalence of microalbuminuria in the SGA group was more than twice that found in the AGA group.

The authors state that these results support the idea that growth retardation in utero has an adverse effect on the development of the kidneys, and that this might predispose individuals to renal disease later in life.