Effect of prenatal corticosteroids on the maturation of renal tubules in preterm infants.

IF 1.3 Q3 UROLOGY & NEPHROLOGY

Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia Pub Date : 2024-10-01 DOI:10.1590/2175-8239-JBN-2023-0035en

Jenny Ponce, Javier Cieza, Reyner Loza, Cristian León, Claudia Nuñez-Mochizaki

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Abstract

Introduction: The benefit of prenatal steroids in fetal lung maturation is well established, but their effect on the kidney has not been studied in detail in humans. Animal models have shown an increase in the expression of Na+/H+ exchangers, Na+-K+-ATPase pumps and aquaporin-1. This study aims to assess the effect of prenatal steroids on the maturation of renal tubules in preterms.

Methods: 21 preterms born between 24 and 34 weeks were included. Participants were divided into two groups according to their exposure to prenatal steroids. The maturation of tubular function was evaluated through the change of the fractional excretion of Na+, K+ and beta 2-microglobulin, the transtubular gradient of K+, urine pH, and osmolality.

Results: The mean age was 30.57 ± 1.8 weeks and the mean weight was 1415 ± 267.8 grams. Baseline differences were not observed, except for a significant difference in the change in urinary excretion of beta 2-microglobulin (Group 1: 1 980 ± 9 075 ng/mL and Group 2: -7 274 ± 10 006 ng/mL, p = 0.04).

Conclusions: Prenatal steroids showed no statistically significant difference on renal tubule maturation in preterms.

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产前皮质类固醇对早产儿肾小管成熟的影响。

导言：产前类固醇对胎儿肺成熟的益处已得到公认，但其对人类肾脏的影响尚未得到详细研究。动物模型显示，Na+/H+交换体、Na+-K+-ATP酶泵和水蒸发素-1的表达增加。本研究旨在评估产前类固醇对早产儿肾小管成熟的影响。方法：21名出生24至34周的早产儿被纳入研究，并根据他们产前服用类固醇的情况被分为两组。通过Na+、K+和β2-微球蛋白的排泄分数、K+的跨肾小管梯度、尿液pH值和渗透压的变化来评估肾小管功能的成熟情况：平均年龄为（30.57 ± 1.8）周，平均体重为（1415 ± 267.8）克。除了尿液中 beta 2-微球蛋白排泄量的变化有显著差异（第 1 组：1 980 ± 9 075 纳克/毫升，第 2 组：-7 274 ± 10 006 纳克/毫升，p = 0.04）外，未观察到基线差异：产前类固醇对早产儿肾小管成熟的影响在统计学上没有显著差异。

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