Renal calcification in preterm infants: follow up at 4–5 years

Abstract

AIM To determine the consequences of renal calcification in preterm infants.

METHODS A cohort of 11 preterm babies was studied at the age of 4 to 5 years. They had had renal calcification as neonates. Seventeen matched controls were also studied. Each child had a renal ultrasound scan, a calcium load test, and a desmopressin test for renal concentrating ability (RCA). The study group also had glomerular filtration rate (GFR) estimated, using the height:creatinine ratio, and tubular phosphate reabsorption, without phosphate load, per glomerular filtration rate (Tp/GFR) calculated.

RESULTS In the study group the median GFR was 61 ml/min/1.73m² (range 46-79 ml/min/1.73m²) and the median calculated Tp/GFR SD score was −0.94 (range −2.8– 0.68). Five children out of the study group had ultrasonic evidence of renal calcification. There was no significant difference between the two groups in renal size, calciuria, before or after calcium load, or RCA. Eight children (three patients, five controls) had an abnormal calcium load test. The RCA of the children in the study and control groups combined was below that of published values, with a median calculated SD score −0.71 (95% CI −1.21 to −0.23).

CONCLUSIONS There was evidence of renal dysfunction in children who had been born preterm. Renal calcification detected in the neonatal period does not seem to be a major predisposing factor for the abnormalities of renal function subsequently observed in these infants.