Preterm birth tied to increased risk for CKD

  • Crump C & al.
  • BMJ
  • 1 May 2019

  • International Clinical Digest
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Takeaway

  • Preterm and early-term birth are strong risk factors for the development of chronic kidney disease (CKD) in childhood through midlife.

Why this matters

  • Preterm birth interrupts a critical period of kidney development and results in fewer nephrons, which has been tied to later hypertension and kidney disease.

Study design

  • Analysis of 4,186,615 single live births in Sweden during 1973-2014, cross-matched with CKD cases from nationwide medical records through 2015.
  • Funding: NIH, Swedish Research Council, Swedish Heart-Lung Foundation, ALF project grant.  

Key results

  • 4305 individuals aged 0-43 years (0.1%) developed CKD (incidence rate, 4.95 per 100,000 person-years [PY]).
  • CKD incidence rate for full-term birth, 4.47 per 100,000 PY (reference).
  • CKD risk from birth to midadulthood vs full-term (4.47 per 100,000 PY):
    • Preterm (
    • Extremely preterm (
    • Early-term (37-38 weeks): aHR=1.30; P<.001 per py.>
  • Association was strongest up to age 9 years (aHR=5.09; P<.001 style="list-style-type:circle;">
  • Risk weakened but remained elevated at ages 10-19 years (aHR=1.97; P<.001 and years p>
  • CKD risk dropped with each additional week of gestation (aHR=0.92; P<.001>
  • Association observed in both sexes, independent of genetic/environmental factors.
  • Limitations

    • Observational design.
    • Lack of detailed CKD data.

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