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Low birth weight
linked to kidney disease
While chronic kidney failure has
established causes such as diabetes and high blood pressure, researchers are finding that
the path to the disease may begin in the womb. Results of a study suggest that low birth
weight may predispose young adults to end-stage renal disease (ESRD) - an advanced form of
kidney failure that often requires an organ transplant.
In a study of 1,230 ESRD patients,
below the age group of 50, investigators found that the odds of developing the disease
were greatest among those with the lowest birth weights. Patients born weighing less than
5.5 pounds were about 40% more likely than those with heavier birth weights to develop
ESRD, according to findings published in the May 22nd issue of the Archives of Internal
Medicine.
'People usually think of low birth
weight as affecting no more than the first year of life,' lead author Dr. Daniel T.
Lackland, from the Medical University of South Carolina in Charleston, told Reuters Health
in an interview. 'But the importance of having a healthy baby extends to health later in
life.'
Other research has implicated low birth
weight in contributing to later asthma, heart disease, high blood pressure and diabetes.
Since low birth weight is twice as common among blacks than whites, Lackland noted, it may
help explain why African Americans face a higher risk for conditions such as high blood
pressure, diabetes and ESRD. Among his study's participants, 70% were black, and more than
half of these participants had underlying high blood pressure or diabetes.
The connection between low birth weight
and adulthood disease has several possible explanations. Poor nutrition during pregnancy
may hinder fetal development enough to have long-term health consequences. Nutrition after
birth may also play a role, according to Lackland. Some researchers have suggested that
when small infants receive a calorie overload to 'catch up' with other babies their age,
this may increase their risk for later weight problems and obesity-related conditions.
Regarding ESRD, Lackland said, its
association with low birth weight may rest in tiny filtering structures in the kidney
called nephrons. The kidney is believed to contain up to one million nephrons, and that
number is set at birth. Studies have shown that premature babies have fewer nephrons,
which may predispose them to kidney problems later on.
The implication here, according to
Lackland's team, is that better prenatal care may help head off adulthood disease.
Lackland noted that low birth weights are becoming more common in part because doctors are
now able to save very premature babies. But he also pointed to inadequate prenatal care as
a factor.
'Women need early, consistent prenatal
care and good nutrition,' Lackland said. Fetal health, he added, may affect lifetime
health 'dramatically.' |
