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Very low birth weight is a risk factor for 1 cause of CKD
November 20, 2008Awareness important for early diagnosis of focal segmental glomerulosclerosis
Individuals who were underweight at birth are at increased risk of developing a condition called secondary focal segmental glomerulosclerosis, according to a study appearing in the January 2009 issue of the Clinical Journal of the American Society Nephrology (CJASN). Because birth history is often overlooked by kidney specialists who take care of adult patients, this risk factor is likely to be under-recognized.
Patients with focal segmental glomerulosclerosis develop scarring of glomeruli, the filtering units of the kidney. This development can cause a decline in kidney function and leakage of protein into the urine.
Low birth weight (less than 5.5 pounds) caused by prematurity or slow growth prior to birth is a risk factor for adult hypertension, coronary heart disease, stroke, diabetes, and other diseases. However, its association with the development of focal segmental glomerulosclerosis has not been reported.
To investigate this potential link, Vivette D'Agati, MD, of the Columbia University College of Physicians & Surgeons in New York City, NY, and her colleagues studied six patients (two women and four men) who had clinical indications of this condition and who were born prematurely and of a very low birth weight. The patients' average age was 32 years, and their average birth weight was 3.3 pounds. They all were born between 22 and 30 weeks of gestation, compared with full-term babies who are born between 37 and 42 weeks.
The researchers performed urine tests that measured whether protein was leaking into the urine and blood tests that indicated how well the patients' kidneys were functioning. They also biopsied the patients' kidneys to analyze the tissue. All of their measurements and tests indicated that the patients had developed focal segmental glomerulosclerosis.
The authors noted that because new nephrons-the filtering structures of the kidney-are not formed after birth, an individual's supply of nephrons is dependent on the environment in the uterus prior to birth and the extent of a fetus' growth and development. If an individual is born with a deficiency of nephrons, their kidneys may become strained, which can lead to declines in kidney function over time. This may be the scenario for individuals who were born prematurely and who go on to develop focal segmental glomerulosclerosis.
"Premature babies with very low birth weights may develop renal disease in adolescence or adulthood that is a consequence of retarded kidney development and overwork of the kidney," said Dr. D'Agati. "Doctors need to be aware of this association so that the condition is not misdiagnosed or treated inappropriately," she added.
American Society of Nephrology
Low birth weight (less than 5.5 pounds) caused by prematurity or slow growth prior to birth is a risk factor for adult hypertension, coronary heart disease, stroke, diabetes, and other diseases. However, its association with the development of focal segmental glomerulosclerosis has not been reported.
To investigate this potential link, Vivette D'Agati, MD, of the Columbia University College of Physicians & Surgeons in New York City, NY, and her colleagues studied six patients (two women and four men) who had clinical indications of this condition and who were born prematurely and of a very low birth weight. The patients' average age was 32 years, and their average birth weight was 3.3 pounds. They all were born between 22 and 30 weeks of gestation, compared with full-term babies who are born between 37 and 42 weeks.
The researchers performed urine tests that measured whether protein was leaking into the urine and blood tests that indicated how well the patients' kidneys were functioning. They also biopsied the patients' kidneys to analyze the tissue. All of their measurements and tests indicated that the patients had developed focal segmental glomerulosclerosis.
The authors noted that because new nephrons-the filtering structures of the kidney-are not formed after birth, an individual's supply of nephrons is dependent on the environment in the uterus prior to birth and the extent of a fetus' growth and development. If an individual is born with a deficiency of nephrons, their kidneys may become strained, which can lead to declines in kidney function over time. This may be the scenario for individuals who were born prematurely and who go on to develop focal segmental glomerulosclerosis.
"Premature babies with very low birth weights may develop renal disease in adolescence or adulthood that is a consequence of retarded kidney development and overwork of the kidney," said Dr. D'Agati. "Doctors need to be aware of this association so that the condition is not misdiagnosed or treated inappropriately," she added.
American Society of Nephrology
Newly found gene variants account for kidney diseases among African-Americans
For the first time, researchers have identified variations in a single gene that are strongly associated with kidney diseases disproportionately affecting African-Americans. This work was conducted by researchers at the National Institutes of Health (NIH) and by NIH-funded investigators at the Johns Hopkins University.
Receptor protein appears to be key in breakdown of kidney filtration
Massachusetts General Hospital (MGH) researchers have identified a new molecular pathway that appears to be involved in urinary protein loss (proteinuria).
Mutant gene causes severe kidney disease in infants
Scientists at the University of Michigan Medical School have discovered a previously unknown cause for a severe, early-onset form of kidney disease and renal failure in children: recessive mutations in a gene called phospholipase C epsilon or PLCE1.
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Focal segmental glomerulosclerosis: a case study with review of pathophysiology.(Continuing Nursing Education): An article from: Nephrology Nursing Journal by Anndee M. Glick (Author) This digital document is an article from Nephrology Nursing Journal, published by Thomson Gale on March 1, 2007. The length of the article is 4510 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser. From the author: Focal segmental glomendosclerosis is a form of chronic kidney disease that causes 3.6% of end stage renal disease cases. While the cause of this disease is multifactoral, the Human Genome Project has identified some specific chromosome sites linked to this disease process. Treatment for focal segmental glomeralosclerosis may include corticosteroids, managing hypertension, and controlling... | |
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