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Very Low Birth Weight Linked to Kidney Disease

Secondary focal segmental glomerulosclerosis found in patients with no other risk factors

MONDAY, Nov. 24 (HealthDay News) -- Very low birth weight and prematurity are associated with secondary focal segmental glomerulosclerosis (FSGS), a glomerular disease involving scarring in the kidney that can lead to kidney failure, according to a report published online Nov. 19 in the Clinical Journal of the American Society of Nephrology.

Jeffrey B. Hodgin, M.D., Ph.D., from Columbia University College of Physicians and Surgeons in New York City, and colleagues describe the cases of two women and four men (mean age 32 years), who appeared to have a secondary form of FSGS based on clinical and pathologic findings. The patients did not have any known risk factors for FSGS.

The researchers found that the patients had a history of prematurity (22 to 30 weeks' gestation) and very low birth weight (450-1420 g). Their mean 24-hour urine protein was 3.3 g/day, mean creatinine clearance was 89 cc/min, mean creatinine was 1.2 mg/dL, and mean serum albumin was 4.1 g/dL. None of the patients had full nephrotic syndrome. A renal biopsy showed FSGS involving a mean of 8.8 percent of glomeruli and features of postadaptive FSGS, with most or all patients having perihilar lesions of sclerosis, glomerulomegaly, and mild foot process effacement (mean 32 percent).

"Our findings support that very low birth weight and prematurity promote the development of secondary FSGS," Hodgin and colleagues conclude. "Because birth history is often not obtained by adult nephrologists, this risk factor is likely to be underrecognized."

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