Risk of Chronic Kidney Diseases Among Individuals Born Preterm: A Population-Based Cohort Study

 

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https://storage.unitedwebnetwork.com/files/1099/91e3cb855eee30e8e7aa7941f1a35d57.pdf
Risk of Chronic Kidney Diseases Among Individuals Born Preterm: A Population-Based Cohort Study

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François
Madore
Latifa Hammouda latifa.hammouda@umontreal.ca Université de Montréal Department of Pediatrics, CHU Sainte-Justine, Faculty of Medicine Montréal Canada -
François Madore f.madore@umontreal.ca Université de Montréal 2 Department of Medicine, Faculty of Medicine Montréal Canada *
Véronique Phan veronique.phan@umontreal.ca Université de Montréal Department of Pediatrics, CHU Sainte-Justine, Faculty of Medicine Montréal Canada -
Marc Dorais marc.dorais.statsciences@gmail.com StatSciences Inc, Notre-Dame-de-l’Ile-Perrot StatSciences Inc Montréal Canada -
Adrien Flahault flahaulta@gmail.com Université de Lorraine Department of Nephrology, Centre Hospitalier Universitaire de Nancy Nancy France -
Anne Monique Nuyt anne.monique.nuyt@umontreal.ca Université de Montréal Department of Pediatrics, CHU Sainte-Justine, Faculty of Medicine Montréal Canada -
Thuy Mai Luu thuy.mai.luu@umontreal.ca Université de Montréal Department of Pediatrics, CHU Sainte-Justine, Faculty of Medicine Montréal Canada -
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Chronic kidney disease (CKD) carries a significant burden in the population. Reduced nephron endowment is considered a key pathway to CKD and can originate from fetal or neonatal life when deleterious conditions impair ongoing nephrogenesis. The extent to which preterm birth is associated with CKD is poorly documented. This study aims to examine the risk of CKD from childhood through adulthood.  

Using administrative health data from the province of Quebec, Canada, this population-based cohort included all individuals born preterm (<37 weeks of gestation) between 1976 and 1995 in Quebec and matched each person to two term-born controls (37–41 weeks). A first diagnosis of CKD up to December 2019 was identified from physician billing claims and hospital data using International Classification of Diseases (ICD)-9 and 10 codes. Cox regression models estimated hazard ratios (HR) for the association between preterm birth and CKDs, adjusting for child and maternal characteristics.

A total of 107 807 preterm and 200 623 term-born individuals (54% males) were included. After a mean follow-up of 33 years (maximum 43 years), 10 159 individuals born preterm (9.5%) and 17 913 individuals born at term (8.9%) had received medical services for a diagnosis of CKD. Preterm birth was associated with CKD with an adjusted HR of 1.10 (95% CI, 1.05–1.13) compared to term-born individuals. The strength of the association was higher among males (1.21; 95% CI, 1.14-1.30) compared to females (HR 1.03; 95% CI, 0.98-1.07).

Prematurity is associated with CKD, especially in males. Preventative strategies to maintain renal health are important in this at-risk population. Future studies are needed to explore the heightened risk in males.

Kewords