<< Вернуться к списку статей журнала

Том 12 №1 2010 год - Нефрология и диализ

Риск прогрессирования стероид-резистентного нефротического синдрома у детей ассоциирован с малой массой тела при рождении

Приходина Л.С. Длин В.В. Игнатова М.С.

Аннотация: В работе представлены результаты ретроспективного 10-летнего наблюдения за течением стероид-резистентного нефротического синдрома у 65 детей, у 5 из которых отмечалась малая масса тела при рождении (<2500 г), обусловленная недоношенностью. У пациентов с малой массой тела при рождении в отличие от детей, рожденных с нормальной массой тела, установлен высокий относительный риск (ОР) быстрого снижения функций почек (СКФ >10 мл/мин/1,73 м /год), составляющий 2,53 (p < 0,05), и низкая пятилетняя почечная выживаемость (0 и 61%; р = 0,00084). Полученные результаты исследования свидетельствуют о влиянии малой массы тела при рождении на течение и прогноз стероид-резистентного нефротического синдрома у детей. Малая масса тела при рождении может рассматриваться в качестве фактора риска прогрессирования заболевания с быстрым снижением почечных функций.

Для цитирования: Приходина Л.С., Длин В.В., Игнатова М.С. Риск прогрессирования стероид-резистентного нефротического синдрома у детей ассоциирован с малой массой тела при рождении. Нефрология и диализ. 2010. 12(1):039-045. doi:

Весь текст

Ключевые слова: дети, стероид-резистентный нефротический синдром, малая масса тела при рождении, прогрессирование, children, steroid-resistant nephrotic syndrome, low birth body weight, progression

Список литературы:

1. Суханова Л.П. Перинатальная ситуация в современной России. Аналитический вестник «Социальные аспекты здоровья населения» // 2007. № 2 (2).
2. Amann K., Plank C., Dotsch J. Low nephron number – a new cardiovascular risk factor in children? // Pediatr Nephrol. 2004. № 19: P. 1319–1323.
3. Annual Report of ERA-EDTA, 2007. www.era-edta.org
4. Barker D.J., Osmond C. Low birth weight and hypertension // BMJ. 1988. Vol. 297: P. 134–135.
5. Barker D.J.P., Osmond C., Golding J. et al. Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease // Br Med J. 1989. Vol. 298. P. 564–567.
6. Barker D.J. Adult consequences of fetal growth restriction // Clin Obstetr Cynecol. 2006. Vol. 49. P. 270–283.
7. Barros F.S., Victora C.G. Increased blood pressure in adolescence who was small for gestational age at birth: a cohort study in Brasil // Int J Epidemiol. 1999. Vol. 28. P. 676–681.
8. Brenner B.M., Garcia D.L., Anderson S. Glomeruli and blood pressure. Less of one, more of the other? // Am J Hypertens. 1988. Vol. 1. P. 335–347.
9. Chesney R. The changing face of childhood nephrotic syndrome in children // Kidney Int. 2004. Vol. 6. P. 1294–1302.
10. Chevalier R.L. Developmental renal physiology of the low birth weight preterm newborn // J Urology. 1996. Vol. 156. P. 714–719.
11. Clark A.G., Barratt T.M. Steroid-responsive nephrotic syndrome. In Barratt T.M., Avner E.D., Harmon W.E. (eds) Pediatr Nephrology, 4th edn. Lippincott, Williams and Wilkins, Baltimore, 1999. P. 731–747.
12. Duncan R.C. et al. Weight at birth and other factors influencing progression of idiopathic membranous nephropathy // Nephrol Dial Transplant. 1994. Vol. 9. P. 875.
13. Dyck R., Klomp H., Tan L., Stang M.R. An association of maternal age and with end-stage renal disease in Saskatchewan. Sub-analysis of registered Indians and those with diabetes // Am J Nephrol. 2003. Vol. 23. P. 395–402.
14. Ehrich J.H.H., Geerlings C., Zivicnjak M., Franke D., Geerlings H., Gellermann J. Steroid-resistant idiopathic childhood nephrosis: overdiagnosed and undertreated // Nephrol Dial Transplant. 2007. Vol. 22. P. 2183–2193.
15. Falkner B., Hulman S., Kushner F. Effect of birth weight on blood pressure and body size in early adolescence // Hypertension. 2004. Vol. 43. P. 203–207.
16. Fan Z.J., Lackland D.T., Lipsitz S.R., Nicholas J.S. The association of low birth weight and chronic renal failure among Medicaid young adults with diabetes and/or hypertension // Public Health Rep. 2006. Vol. 121. P. 239–244.
17. Hershkovitz D., Burbea Z., Skorecki K., Brenner B.M. Fetal programming of adult kidney disease: cellular and molecular mechanisms // J Am Soc Nephrol. 2007. Vol. 2. P. 334–342.
18. Hinchliffe S.A., Sargent P.H., Hovard C.V., Chan Y.F. et al. Human intrauterine renal growth expressed in absolute number of glomeruli assessed by the dissector method and Cavalieri principle // Lab Invest. 1991. Vol. 64. P. 777–784.
19. Hodgin J.B., Rasoulpour M., Markowitz G.S., D’Agati V.D. Very low birth weight a risk factor for focal segmental glomerulosclerosis // Clin J Soc Nephrol. 2009. Vol. 4. P. 71–76.
20. Hostetter T.H et al. Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation // Am J Physiol. 1981. Vol. 241. F85–F93.
21. Hostetter T.H. Hyperfiltration and glomerulosclerosis // Semin Nephrol. 2003. Vol. 23. P. 194–199.
22. Hoy W.E., Douglas-Denton R.N., Hughson M.D. et al. A stereological study of glomerular number and volume: Preliminary findings in a multiracial study of kidney at autopsy // Kidney Int. 2003. Vol. 63. S31–S37.
23. Hoy W.E., Hughson M.D., Bertram J.F., Douglas-Denton R., Amann K. Nephron number, hypertension, renal disease, and renal failure // J Am Soc Nephrol. 2005. Vol. 16. P. 2557–2564.
24. Hoy W.E., Rees M., Kile E. et al. A new dimension to the Barker hypothesis: low birthweight and susceptibility to renal disease // Kidney Int. 1999. Vol. 56. P. 1072–1077.
25. Hughson M.D., Farris A.B. 3rd, Douglas-Deton R., Hoy W.E., Bertram J.F. Glomerular number and size in autopsy kidneys: the relationship to birth weight // Kidney Int. 2003. Vol. 63. P. 2113–2122.
26. Huxley R., Neil A., Collins R. Unraveling the fetal origins hypothesis: is there an inverse association between birth-weight and subsequent blood pressure? // Lancet. 2002. Vol. 360. P. 659–665.
27. Keijzer-Ween M.G., Schrevel M., Finken M.G.G. et al. Microalbuminuria and lower glomerular filtration rate and young adult age in subjects born very premature and after intrauterine growth retardation // J Am Soc Neph. 2005. 16. Vol. P. 2762–2768.
28. Keller G., Zimmer G., Mali G., Ritz E., Amann K. Nephron number in patients with primary hypertension // N Engl J Med. 2003. Vol. 348. P. 101–108.
29. Kim J.S., Bellew C.A., Silverstein DM., Aviles D.H. et al. High incidence of initial and late steroid resistance in childhood nephrotic syndrome // Kidney Int. 2005. Vol. 68. P. 1275–1281.
30. Lackland D.T., Bendall H.E., Osmond C. et al. Low birth weights contribute to high rates of early-onset chronic renal failure in the Southeastern United States // Arch Intern Med. 2000. Vol. 160. P. 1472–1476.
31. Law C.M., Egger P., Dada O., Delgado H. et al. Body size at birth and blood pressure among children in developing countries // Int J Epidemiol. 2001. Vol. 30. P. 52–57.
32. Law C.M., Shiell A.W., Newsome C.A., Syddall H.E. et al. Fetal, infant, and childhood growth and adult blood pressure: a longitudinal study from birth to 22 years of age // Circulation. 2002. Vol. 105. P. 1088–1092.
33. Law C.M., Shiell A.W. Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature // J Hypertens. 1996. Vol. 14. P. 935–941.
34. Leroy B., Josset P., Morgan G. et al. Intrauterine growth retardation (IUGR) and nephron deficit: Preliminary study in man // Pediatr Nephrol. 1992. Vol. 6. C21.
35. Levitt N.S., Steyn K., De Wet T., Mortell C. et al. An inverse relation between blood pressure and birth weight among 5 year old children from Soweto, South Africa // J Epidemiol Community Health. 1999. Vol. 53. P. 264–268.
36. Malalich R., Reyes L., Herrera M. et al. Relationship between weight and birth and number and size of renal glomeruli in humans: A histomorphometric study // Kidney Int. 2000. Vol. 58. P. 770–773.
37. McKinney P.A., Feltbower R.G., Brocklebank J.T. et al. Time trends and ethnic patterns of childhood nephrotic syndrome in Yorkshire, UK // Pediatr Nephrol. 2001. Vol. 16. P. 1040–1044.
38. Merlet-Benichou C., Gilbert T., Muffat-Jolly M. et al. Intrauterine growth retardation leads to a permanent nephron deficit in the rat // Pediatr Nephrol. 1994. Vol. 8. P. 175–180.
39. Moore V.M., Cockington T.A., Royan P., Robinson J.S. The relationship between birth weight and blood pressure amplifies from childhood to adulthood // J Hypertens. 1999. Vol. 17. P. 883–888.
40. Na Y.W., Yang H.J., Choi J.H., Yoo K.H. et al. Effect of intrauterine growth retardation on the progression of nephrotic syndrome // Am J Nephrol. 2002. Vol. 22. P. 463–467.
41. Nathanson S., Moreau E., Merlet-Benichou C. et al. In utero and vitro exposures to beta-lactams impair kidney development in the rat // J Am Soc Neph. 2000. Vol. 11. P. 874–884.
42. National Kidney Foundation Kidney Disease Outcomes Quality Initiatives. K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease Evaluation Classification Stratification // Am J Kidney Disease 2002. Vol. 39 (2Suppl. 1). S1–266.
43. Nelson R.G., Morgenstern H., Bennett P.H. Birth weight and kidney disease in Pima Indians with type 2 diabetes mellitus // Am J Epidemiol. 1998. Vol. 148. P. 650–656.
44. Nelson R.G. Intrauterine determinants of diabetic kidney disease in disadvantage population // Kidney Int. 2003. S13–S16.
45. Nigam S.K., Aperia A.C., Brenner B.M. Developmental and maturation of the kidney. In: Brenner B.M. (ed). Brenner and Rector’s the kidney // W.B. Saunders Company. Philadelphia, 1996. P. 72–98.
46. Plank C., Ostreicher I., Dittrich K., Waldherr R., Voigt M. et al. Low birth weight, but not postnatal weight gain, aggravates the course of nephrotic syndrome // Pediatr Nephrol. 2007. Vol. 22. P. 1881–1889.
47. Plank C., Ostreicher I., Hartner A., Marek I. et al. Intrauterine growth retardation n aggravates the course of acute mesangioproliferative glomerulonephritis in the rat // Kidney Int. 2006. Vol. 70. P. 1974–1982.
48. Porteus S., Torban E., Cho N.P. et al. Primary renal hypoplasia in humans and mice with mutations: evidence of increased apoptosis in fetal kidneys of PAX2 (INeu) +/– mutant mice // Hum Mol genet. 2000. Vol. 9. P. 1–11.
49. Quan A. Fetopathy associated with exposure to angiotensin converting enzyme inhibitors and angiotensin receptor antagonists // Early Hum Dev. 2006. Vol. 82. P. 23–28.
50. Ramirez S.P., Hsu S.I., McClellan W. Low birth weight is a risk factor for proteinuria in multiracial southeast Asian Pediatric Population // Am J Kidney Dis. 2001. Vol. 38. P. 1045–1054.
51. Reyes L., Manalich R. Long-term consequences of low birth weight // Kidney Int. 2005. Vol. 97. S107–S111.
52. Rio M., Kaskel F. Evaluation and management of steroid-unresponsive nephrotic syndrome // Current Opinion in Pediatrics. 2008. Vol. 20. P. 151–156.
53. Schreuder M.F., van Wijk J.A., Delemarre-van de Waal H.A. Intrauterine growth restriction increases blood pressure and central pulse pressure measured with telemetry in aging rats // J Hypertens. 2006. Vol. 24. P. 1337–1343.
54. Schwartz G., Brion L.P., Spitzer A. The use of plasma creatinine concentration to estimate glomerular filtration rate in infancy, childhood and adolescence // Pediatr Clin North Am. 1987. Vol. 34. P. 571–590.
55. Shankaran S., Das A., Bauer C.B. et al. Fetal origin of childhood disease // Arch Pediatr Adolelesc Med. 2006. Vol. 160. P. 977–981.
56. Sheu J.N., Chen J.N. Minimal change nephrotic syndrome in children with intrauterine growth retardation // Am J Kidney Dis. 2001. Vol. 37. P. 909–914.
57. Spencer J., Wang Z., Hoy W.E. et al. Low birth weight and reduced renal volume in Aboriginal children // Am J Kid Dis. 2001. Vol. 37. P. 915–920.
58. Teeninga N., Schreuder M.F., Bökenkamp A. et al. Influence of low birth weight on minimal change nephrotic syndrome in children, including a meta-analysis // Nephrol Dial Transpl. 2008. Vol. 23 (5). P. 1615–1620.
59. The Infant Health and Development Program: Enhancing the outcomes of low birth weight, premature infants // JAMA. 1990. Vol. 263 [22]. P. 3035–3042.
60. Uiterwaal C.S., Anthony S., Launer L.J., Witteman J.C. et al. Birth weight, growth, and blood pressure: an annual follow-up study of children aged 5 through 21 years // Hypertension. 1997. Vol. 30. P. 267–271.
61. Vikse B.E. et al. Low birth weight increases risk for end stage of renal disease // J Am Soc Nephrol. 2008. Vol. 19. P. 151–157.
62. Walker S.P., Gaskin P., Powel S.A. et al. The effect of birth weight and postnatal linear growth retardation on blood pressure at age 11–12 years // J Epidemiol Community Health. 2001. Vol. 55. P. 394–398.
63. Warady B.A., Chadha V. Chronic kidney disease in children: the global perspective // Pediatr Nephrol. 2007. Vol. 22. P. 1999–2009.
64. Welham S.J., Wade A., Woolf A.S. Protein restriction in pregnancy is associated with increased apoptosis of mesenchymal cells at the start of rat metanephrogenesis // Kidney Int. 2002. Vol. 61. P. 1231–1242.
65. White S.L., Percovic V., Cass A., Chang C.L. et al. Low birth weight in Antecedent of CKD in later life? A systematic review of observational studies // Am J Kid Dis. 2009. Vol. 54. P. 248–261.
66. Wong W. Idiopathic nephrotic syndrome in New Zealand children, demographic, clinical features, initial management and outcome after twelve-month follow-up: results of a three-year national surveillance study // J Paediatr Child Health. 2007. Vol. 43. P. 337–341.
67. Yudkin J.S., Matyn C.N., Phillips D.L., Gale C.R. Association of microalbuminuria with intrauterine growth retardation // Nephron. 2001. Vol. 89. P. 309–314.
68. Zhang S.L., Moini B., Ingelfinger J.R. Angiotensin II increases 2004 Pax-2 expression in fetal kidney cells via the AT2 receptor // J Am Soc Nephrol. 2004. Vol. 15. P. 1452–1465.
69. Zidar N. et al. Effect of intrauterine growth retardation on the clinical course and prognosis of IgA glomerulonephritis in children // Nephron. 1998. Vol. 79. P. 28–32.
70. Zidar N. et al. Unfavorable course of minimal change nephrotic syndrome in children with intrauterine growth retardation. Kidney Int. 1998. Vol. 54. P. 1320–1323.
71. Zimanyi M.A., Denton K.M., Forbes J.M., Thallas-Bonke V. et al. A developmental nephron deficit in rats is associated with increased susceptibility to a secondary renal injury due to advanced glycation end-products // Dietologia. 2006. Vol. 49. P. 801–810.

Другие статьи по теме

• Полиморфные маркеры гена нефрина ( ) при спорадическом стероид-резистентном нефротическом синдроме у детей
• Такролимус в лечении стероид-резистентного нефротического синдрома у детей (Предварительные результаты одноцентрового исследования)
• Клинико-генетическая гетерогенность cтероид-резистентного нефротического синдрома у детей (Обзор литературы)
• Исследование генетических причин врожденного и инфантильного нефротического синдрома у российских детей