Papers

7 2017

Polycythemia, capillary rarefaction, and focal glomerulosclerosis in two adolescents born extremely low birth weight and premature

PEDIATRIC NEPHROLOGY
  • Nariaki Asada
  • ,
  • Takanori Tsukahara
  • ,
  • Megumi Furuhata
  • ,
  • Daisuke Matsuoka
  • ,
  • Shunsuke Noda
  • ,
  • Kuniaki Naganuma
  • ,
  • Akinori Hashiguchi
  • ,
  • Midori Awazu

Volume
32
Number
7
First page
1275
Last page
1278
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1007/s00467-017-3654-z
Publisher
SPRINGER

Low birthweight infants have a reduced number of nephrons and are at high risk of chronic kidney disease. Preterm birth and/or intrauterine growth restriction (IUGR) may also affect peritubular capillary development, as has been shown in other organs.
We report two patients with a history of preterm birth and extremely low birthweight who showed polycythemia and renal capillary rarefaction. Patient 1 and 2, born at 25 weeks of gestation with a birthweight of 728 and 466 g, showed mild proteinuria at age 8 and 6 years, respectively. In addition to increasing proteinuria, hemoglobin levels became elevated towards adolescence and their serum erythropoietin (EPO) was high despite polycythemia. Light microscopic examination of renal biopsy specimens showed glomerular hypertrophy, focal segmental glomerulosclerosis, and only mild tubulointerstitial fibrosis. A decrease in the immunohistochemical staining of CD31 and CD34 endothelial cells in renal biopsy specimens was consistent with peritubular capillary rarefaction.
Since kidney function was almost normal and fibrosis was not severe, we consider that the capillary rarefaction and polycythemia associated with elevated EPO levels were largely attributable to preterm birth and/or IUGR.

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Link information
DOI
https://doi.org/10.1007/s00467-017-3654-z
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000401926600022&DestApp=WOS_CPL