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杜 越, 王 亚. [The association between preterm birth and hypertension]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:871-878. [PMID: 39148394 PMCID: PMC11334553 DOI: 10.7499/j.issn.1008-8830.2312129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 06/04/2024] [Indexed: 08/17/2024]
Abstract
In recent years, the number of premature births worldwide has been increasing, and their long-term prognoses, particularly the cardiovascular outcomes of preterm individuals in adulthood, have become a growing concern. Adults who were born prematurely are at a higher risk for cardiovascular diseases, which may be related to changes in cardiovascular structure, renal structure alterations, changes in body composition, and overactivation of the hypothalamic-pituitary-adrenal axis. To improve the outcomes for preterm individuals, long-term follow-up monitoring and effective prevention and treatment measures are necessary. This article aims to review the relevant literature, summarize the risks and mechanisms of hypertension during childhood and adulthood in those born prematurely, and enhance awareness and understanding of the risk of hypertension in adults who were born prematurely.
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Alao MA, Ibrahim OR, Asinobi AO, Ademola DA, Ekrikpo UE, Olowu WA. Evaluation of eGFR methods in a sub-Saharan African community-based pediatric population. Pediatr Nephrol 2024; 39:2435-2449. [PMID: 38488898 DOI: 10.1007/s00467-024-06323-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Accurate assessment of the estimated glomerular filtration rate (eGFR) plays a pivotal role in the early detection, management, and optimal medication dosing for chronic kidney disease (CKD). However, validation of eGFR, utilizing cystatin C-based equations, is limited in African children and adolescents with CKD. We evaluate the agreement of eGFR equations incorporating both cystatin C and creatinine in this specific population. METHODS This community-based study assessed CKD in children (2-15 years) using cystatin C and serum creatinine. eGFR agreement with the reference was evaluated with Bland-Altman plots, ROC curves, and Lin's CCC, using the Under-25 serum creatinine-cystatin C equation as the reference standard. Pairwise ROC comparisons assess the statistical differences in estimation equation agreement. RESULTS Among 666 children (mean age, 7.8 ± 3.8 years; 48.6% male), CKD prevalence was 11.6% (95% CI, 9.2-14.2%). Notably, the Chehade equation, using combined biomarkers, aligned best with the reference, displaying the lowest mean deviation (- 0.59; 95% CI, - 1.19 to 0.01), superior agreement (P10, 91.0%; P30, 96.70%), and highest discriminatory power (0.989). In contrast, CKD-EPI 2012 cystatin C had the highest mean deviation (- 35.90) and lowest discriminatory power (0.79). Equations combining creatinine and cystatin C (Schwartz, Chehade, Full Age Spectrum) demonstrated strong positive Lin's CCC with CKiD U25 creatinine-cystatin C, while Bouvet showed a notably weak correlation (Lin's CCC, 0.22). CONCLUSION In African children with CKD, the Chehade, CKiD Under 25 creatinine-based equations, and the Full Age Spectrum equations show promise for CKD diagnosis. However, a measured GFR is essential to identifying the most accurate eGFR equation in this population.
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Affiliation(s)
- Michael Abel Alao
- College of Medicine, University of Ibadan, CW22+H4W, Queen Elizabeth I I Road, Agodi, Ibadan, 200285, Oyo, Nigeria.
| | | | - Adanze Onyenonachi Asinobi
- College of Medicine, University of Ibadan, CW22+H4W, Queen Elizabeth I I Road, Agodi, Ibadan, 200285, Oyo, Nigeria
| | - Debo Adebowale Ademola
- College of Medicine, University of Ibadan, CW22+H4W, Queen Elizabeth I I Road, Agodi, Ibadan, 200285, Oyo, Nigeria
| | | | - Wasiu Adekunle Olowu
- Paediatric Nephrology and Hypertension Unit, Obafemi Awolowo University Teaching Hospitals Complex, Obafemi Awolowo University, PMB 5538, Ile-Ife, 220005, Osun, Nigeria
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George RP, Flynn JT. Birth History and the Risk for Development of Hypertension in Adolescence. Kidney Int Rep 2024; 9:1574-1576. [PMID: 38899211 PMCID: PMC11184377 DOI: 10.1016/j.ekir.2024.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Affiliation(s)
- Roshan P. George
- Department of Pediatrics, Emory University and Division of Nephrology, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Joseph T. Flynn
- Department of Pediatrics, University of Washington School of Medicine; and Division of Nephrology, Seattle Children’s Hospital, Seattle, Washington, USA
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Zhang L, Xu Y, Li X, Yang F, Wang C, Yu C. Multivitamin consumption and childhood asthma: a cross-sectional study of the NHANES database. BMC Pediatr 2024; 24:84. [PMID: 38297283 PMCID: PMC10829257 DOI: 10.1186/s12887-024-04540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Dietary intakes of vitamins are associated with asthma. However, previous studies mainly explored the association between a single vitamin intake and asthma, which did not take the multivitamins into consideration. Herein, this study aims to explore the overall effect of dietary multivitamins consumption on childhood asthma. METHODS Data of children and adolescents (aged 2-17 years old) were extracted from the National Health and Nutrition Examination Survey (NHANES) database in 2015-2018 in this cross-sectional study. Weighted univariate logistic regression analysis was used to screen covariates. The association between multivitamins (including vitamin A, C, D, E, B1, B2, B6, B12, K, niacin, folic acid, and choline) and childhood asthma was explored using univariate and multivariate logistic regression analyses. The evaluation indexes were odds ratio (OR) and 95% confidence interval (CI). We further introduced the Bayesian kernel machine regression (BKMR) to assess the joint effect of the twelve vitamins on childhood asthma, the impact of an individual vitamin as part of a vitamin mixture, and the potential interactions among different vitamins. RESULTS Among 4,715 eligible children and adolescents, 487 (10.3%) had asthma. After adjusting for covariates including race, family history of asthma, pregnant smoking, BMI Z-score, energy intake, breast feeding, and low birth weight, we found that for each 1-unit increase in vitamin K consumption, the odds of childhood asthma decreased 0.99 (P=0.028). The overall effect analysis reported a trend of negative relationship between the multivitamins and childhood asthma, especially at the 75th percentile and over. According to the BKMR models, when other vitamins are fixed at the median level, the odds of childhood asthma increased along with the elevated vitamin D (VD) and vitamin B2 (VB2), whereas along with the depressed vitamin C (VC). In addition, no potential interaction has been found between every two vitamins of multivitamins on childhood asthma. CONCLUSION Among children and adolescents who have high-risk of asthma, it may be beneficial to increase dietary consumption of multivitamins. Our findings recommended that children and adolescents should increase the intake of VC-rich foods, whereas control the dietary consumption of VD and VB2 in daily life.
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Affiliation(s)
- Li Zhang
- Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, P.R. China
| | - Yali Xu
- Department of Pediatric Center, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, P.R. China
| | - Xuemei Li
- Department of Pediatrics, Women and Children's Hospital of Chongqing Medical University, Chongqing, 401147, P.R. China
| | - Fan Yang
- Department of Pediatrics, The Fifth People's Hospital of Chongqing, No.24 Renji Road, Nanan District, Chongqing, 400062, P.R. China
| | - Chengxiu Wang
- Department of Pediatrics, The Fifth People's Hospital of Chongqing, No.24 Renji Road, Nanan District, Chongqing, 400062, P.R. China
| | - Chunmei Yu
- Department of Pediatrics, The Fifth People's Hospital of Chongqing, No.24 Renji Road, Nanan District, Chongqing, 400062, P.R. China.
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Basta J, Robbins L, Stout L, Brennan M, Shapiro J, Chen M, Denner D, Baldan A, Messias N, Madhavan S, Parikh SV, Rauchman M. Deletion of NuRD component Mta2 in nephron progenitor cells causes developmentally programmed FSGS. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.18.562984. [PMID: 38948707 PMCID: PMC11213133 DOI: 10.1101/2023.10.18.562984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Low nephron endowment at birth is a risk factor for chronic kidney disease. The prevalence of this condition is increasing due to higher survival rates of preterm infants and children with multi- organ birth defect syndromes that affect the kidney and urinary tract. We created a mouse model of congenital low nephron number due to deletion of Mta2 in nephron progenitor cells. Mta2 is a core component of the Nucleosome Remodeling and Deacetylase (NuRD) chromatin remodeling complex. These mice developed albuminuria at 4 weeks of age followed by focal segmental glomerulosclerosis (FSGS) at 8 weeks, with progressive kidney injury and fibrosis. Our studies reveal that altered mitochondrial metabolism in the post-natal period leads to accumulation of neutral lipids in glomeruli at 4 weeks of age followed by reduced mitochondrial oxygen consumption. We found that NuRD cooperated with Zbtb7a/7b to regulate a large number of metabolic genes required for fatty acid oxidation and oxidative phosphorylation. Analysis of human kidney tissue also supported a role for reduced mitochondrial lipid metabolism and ZBTB7A/7B in FSGS and CKD. We propose that an inability to meet the physiological and metabolic demands of post-natal somatic growth of the kidney promotes the transition to CKD in the setting of glomerular hypertrophy due to low nephron endowment.
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Tian Q, He C, Wang Z, Hun M, Fu YC, Zhao M, He Q. Relationship between serum uric acid and estimated glomerular filtration rate in adolescents aged 12-19 years with different body mass indices: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1138513. [PMID: 37564990 PMCID: PMC10410468 DOI: 10.3389/fendo.2023.1138513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/28/2023] [Indexed: 08/12/2023] Open
Abstract
Background Globally, chronic kidney disease (CKD) is a growing public health concern. Serum uric acid (SUA) is an easily detectable and readily available biochemical indicator that has long been recognized as an independent risk factor for CKD. In addition, studies have indicated a potential relationship between SUA and body mass index (BMI). However, studies on the effect of SUA levels on the estimated glomerular filtration rate (eGFR) in adolescents with different BMIs are very rare. Methods Weighted multiple regression analysis was used to estimate the independent relationship between SUA and log-transformed eGFR. Additionally, we used a weighted generalized additive model and smooth curve fitting to describe the nonlinear relationships in the subgroup analysis. Results First, SUA was negatively associated with log-transformed eGFR even after adjusting for all covariates (β=-0.0177, 95% CI: -0.0203-0.0151, P<0.0001). Second, the results of the stratified analysis found that after adjusting for all covariates, the decrease in log-transformed eGFR due to changes in per SUA levels (Per 1, mg/dL increase) was elevated in female adolescents (β=-0.0177, 95% CI: -0.0216, -0.0138, P<0.0001), adolescents aged 12-15 years (β=-0.0163, 95% CI: -0.0200, -0.0125, P<0.0001) and black (β=-0.0199, 95% CI: -0.0251, -0.0148, P<0.0001) adolescents. Furthermore, we found that adolescents with a higher BMI had higher SUA levels, and the effect of SUA on eGFR was significantly higher in underweight adolescents (β=-0.0386, 95% CI: (-0.0550, -0.0223), P<0.0001). Conclusion SUA was negatively associated with the eGFR in adolescents aged 12-19 years. Furthermore, we found for the first time that SUA affects the eGFR differently in adolescents with different BMIs. This effect was particularly significant in underweight adolescents.
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Affiliation(s)
- Qiuwei Tian
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Caixia He
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zisai Wang
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Marady Hun
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yi-Cheng Fu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Mingyi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qingnan He
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
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