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Renal echo-3D and microalbuminuria in children of diabetic mothers: a preliminary study

Published online by Cambridge University Press:  10 April 2013

B. Cappuccini ,
E. Torlone ,
C. Ferri ,
S. Arnone ,
S. Troiani ,
V. Bini ,
G. Bellomo ,
G. Barboni  and
G. Di Renzo
B. Cappuccini
Affiliation:
Department of Neonatology, University Hospital of Perugia, Perugia, Italy
E. Torlone
Affiliation:
MISEM, University Hospital of Perugia, Perugia, Italy
C. Ferri
Affiliation:
Clinical Pathology, University Hospital of Perugia, Perugia, Italy
S. Arnone
Affiliation:
MISEM, University Hospital of Perugia, Perugia, Italy
S. Troiani
Affiliation:
Pediatric Cardiology, University Hospital of Perugia, Perugia, Italy
V. Bini
Affiliation:
MISEM, University Hospital of Perugia, Perugia, Italy
G. Bellomo
Affiliation:
Department of Nephrology, MVT Hospital, Todi (PG), Italy
G. Barboni
Affiliation:
Department of Neonatology, University Hospital of Perugia, Perugia, Italy
G. Di Renzo*
Affiliation:
Department of Obstetrics/Gynecology and Centre of Perinatal, Santa Maria della Misericordia Hospital, University Hospital of Perugia, Perugia, Italy
*
*Address for correspondence: G. Di Renzo, Department of Obstetrics/Gynecology and Centre of Perinatal, Perinatal Medicine, Santa Maria della Misericordia Hospital, University Hospital of Perugia, Perugia, Italy. (Emails: elisabetta.torlone@ospedale.perugia.it, direnzo@unipg.it)
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Abstract

Maternal diabetes has assumed epidemic relevance in recent years and animal studies have provided some evidence that it may cause abnormalities in renal development and a reduction in nephron endowment in the offspring; however, human data are lacking. The renal cortex contains ∼95% of the glomeruli and its volume could be taken as a surrogate measure of glomerular number; based on this assumption, we measured renal cortex volume and in addition, microalbuminuria in a homogeneous sample of 42 children of diabetic (pregestational, n = 13, and gestational, n = 29) mothers, compared with 21 healthy children born of non-diabetic mothers. The offspring of diabetic mothers showed a significant reduction of renal cortex volume and higher albumin excretion compared with controls, possibly attributable to a reduction in the number of nephrons and the difference was statistically significant (P < 0.001). Although further studies on a larger sample are necessary, our preliminary findings suggest that maternal diabetes may affect renal development with sequelae later in life, requiring closer monitoring and follow-up. Furthermore, the importance of strict maternal diabetes management and control must be emphasized.

Keywords

diabetesmicroalbuminuriarenal cortical volumerenal development
Type
Brief Report
Information
Journal of Developmental Origins of Health and Disease , Volume 4 , Issue 4 , August 2013 , pp. 285 - 289
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2013 

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References

1.Simeoni, U, Barker, DJ. Offspring of diabetic pregnancy: long-term outcomes. Semin. Fetal Neonatal Med. 2009; 14, 114–124.CrossRefGoogle ScholarPubMed
2.Schreuder, MF. Safety in glomerular numbers. Educational Reviews Pediatr Nephrol. 2012; 27, 1881–1887.Google Scholar
3.Keller, G, Zimmer, G, Mall, G, Ritz, E, Amann, K. Nephron number in patients with primary hypertension. N Engl J Med. 2003; 348, 101–108.CrossRefGoogle ScholarPubMed
4.Luyckx, VA, Brenner, BM. The clinical importance of nephron mass. J Am Soc Nephrol. 2010; 21, 898–910.Google Scholar
5.Guignard, JP. Nephron deficit: causes and late consequences. Arch Pediatr. 2005; 6, 726–727.Google Scholar
6.Metzger, BE, Gabbe, SG, Persson, B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33, 676–682.Google Scholar
7.Zimani, MA, Denton, KM, Forbes, JM, et al. A developmental nephron deficit in rats is associated with increased susceptibility to a secondary renal injury due to advanced glycation end-products. Diabetologia. 2006; 49, 801–810.Google Scholar
8.Pégorier, M. Exposure to maternal diabetes induces salt-sensitive hypertension and impairs renal function in adult rat offspring. Diabetes. 2008; 57, 2167–2175.Google Scholar
9.Van Huygen, JP, Viltard, M, Nehiti, T. Expression of matrix metalloproteinase MMp-2 and MMP-9 is altered during nephrogenesis in fetuses from diabetic rats. Lab Invest. 2007; 87, 680–689.Google Scholar
10.Tran, S, Chen, JW, Chenier, I, et al. Maternal diabetes modulates renal morphogenesis in offspring. J Am Soc Nephrol. 2008; 19, 943–952.Google Scholar
11.Chen, YW, Chenier, I, Tran, S, et al. Maternal diabetes programs hypertension and kidney injury in offspring. Pediatr Nephrol. 2010; 25, 1319–1329.CrossRefGoogle ScholarPubMed
12.Khalil, CA, Travert, F, Fetita, S, et al. Fetal exposure to maternal type 1 diabetes is associated with renal dysfunction at adult age. Diabetes. 2010; 59, 2631–2636.Google Scholar
13.Myrie, SB, McKnight, LL, Van Vliet, BN, et al. Low birth weight is associated with reduced nephron number and increased blood pressure in adulthood in a novel spontaneous intrauterine growth-restricted model in Yucatan miniature swine. Neonatology. 2011; 100, 380–386.Google Scholar
14.Konje, JC, Okaro, Cl, Bell, Sc, de Chazal, R, Taylor, DJ. A cross-sectional study of changes in fetal renal size with gestation in appropriate- and small-for-gestation-age fetuses. Ultrasound Obstet Gynecol. 1997; 10, 22–26.Google Scholar
15.Manalich, R, Reyes, L, Herrera, M, Melendi, C, Fundora, I. Relationship between weight at birth and the number and size of renal glomeruli in humans: a histomorphometric study. Kidney Int. 2000; 58, 770–773.Google Scholar
16.Amin, R, Turner, AR, van Aken, S, et al. The relationship between microalbuminuria and glomerular filtration rate in young type 1 diabetic subjects: The Oxford Regional Prospective Study. Kidney Int. 2005; 68, 1740–1749.CrossRefGoogle ScholarPubMed
17.Singh, A, Satchell, SC. Microalbuminuria: causes and implications. Pediatr Nephrol. 2011; 26, 1957–1965.CrossRefGoogle ScholarPubMed
18.Heijmans, ET, Tobi, EW, Stein, AB, et al. Persistent epigenetic differences associated with prenatal exposure to famine in humans. PNAS. 2008; 105, 17046–17049.CrossRefGoogle ScholarPubMed
19.Tobi, EW, Lumey, LH, Talens, RP, et al. DNA methylation differences after exposure to prenatal famine are common and timing- and sex-specific. Hum Mol Genet. 2009; 18, 4046–4053.Google Scholar
20.Kandasamy, Y, Smith, R, Wright, IMR, Lumbers, ER. Relationship between glomerular filtration rate and kidney volume in low-birth-weight neonates. J Nephrol. 2012; doi:10.5301/jn.5000220.Google ScholarPubMed