早产/低出生体重相关远期慢性肾脏病发病机制研究进展

Research progress in the pathogenesis of long-term chronic kidney disease associated with preterm birth and low birth weight

随着新生儿重症监护技术的发展,早产儿尤其是超早产儿出生率及存活率逐渐升高,但是伴随而来的早产儿远期预后问题也逐渐凸显。在肾脏疾病领域,现有临床研究数据显示早产/低出生体重儿在儿童期和成人期慢性肾脏病发病率显著高于足月儿,提示早产/低出生体重是远期慢性肾脏病发生的危险因素,但是目前国内外对早产/低出生体重相关远期慢性肾脏病关注度低,对涉及其中的机制认识不足。现有研究认为肾单位减少学说、足细胞丢失学说是慢性肾脏病的重要机制,但详细分子机制尚不明确。因此本文对早产/低出生体重相关远期慢性肾脏病发病机制的研究进展进行综述。

With the development of neonatal intensive care,both the live birth rate and survival rate of preterm infants,especially in extremely preterm infants,have escalated.However,the long-term adverse prognosis of preterm infants became increasingly conspicuous.In the field of kidney disease,the existing clinical data have substantiated a higher susceptibility to chronic kidney disease(CKD)development during childhood or adulthood in preterm and low-birth-weight infants when compared with full-term infants.This suggests that preterm and/or low birth weight increases the risk for long-term CKD.Nonetheless,little attention has been paid to long-term CKD associated with preterm and/or low birth weight and the mechanism involved in this process is unknown.Current studies have suggested that reduced nephron and podocyte depletion are involved in this process,but detailed molecular mechanism remains inadequate.Therefore,this article reviews the research progress of long-term CKD correlated with preterm and/or low birth weight.