HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.01700408v1 4/1/71    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hodgin, J. B. Articles by D'Agati, V. D. Search for Related Content PubMed PubMed Citation Articles by Hodgin, J. B. Articles by D'Agati, V. D. Related Collections Related Articles

Very Low Birth Weight is a Risk Factor for Secondary Focal Segmental Glomerulosclerosis

Jeffrey B. Hodgin^*, Majid Rasoulpour, Glen S. Markowitz^*, and Vivette D. D'Agati^*

^* Department of Pathology, Columbia University, College of Physicians & Surgeons, New York, New York; Division of Nephrology, Connecticut Children's Medical Center, Hartford, Connecticut

Correspondence: Dr. Vivette D. D'Agati, Department of Pathology, Columbia University, College of Physicians & Surgeons, 630 West 168th Street, VC14-224, New York, NY 10032. Phone: (212) 305-7460; Fax: (212) 342-5380; E-mail: vdd1{at}columbia.edu

Background and objectives: Low birth weight (LBW), resulting from intrauterine growth retardation (IUGR) or prematurity, is a risk factor for adult hypertension and chronic kidney disease. LBW is associated with reduced nephron endowment and increased glomerular volume; however, the development of secondary focal segmental glomerulosclerosis (FSGS) has not been reported previously.

Design, setting, participants & measurements: The authors describe six patients with clinical and pathologic findings suggesting a secondary form of FSGS, in whom a history of prematurity and very LBW was obtained. No other known causes of secondary FSGS were identified.

Results: The cohort consisted of two women and four men with a mean age of 32 yr. Patients were born at 22 to 30 wk gestation with mean birth weight of 1054 g (range 450 to 1420 g). Mean 24-h urine protein was 3.3 g/d (range 1.3 to 6.0 g/d), mean creatinine clearance 89 cc/min (range 71 to 132 cc/min), mean creatinine 1.2 mg/dl (range 0.9 to 1.5 mg/dl), and mean serum albumin 4.1 g/dl (range 3.4 to 4.8 g/dl). No patient had full nephrotic syndrome. Renal biopsy revealed FSGS involving a minority (mean 8.8%) of glomeruli, with a predominance of perihilar lesions of sclerosis (five of six patients), glomerulomegaly (all six patients), and only mild foot process effacement (mean 32%), all features typical of postadaptive FSGS.

Conclusions: Our findings support that very LBW and prematurity promote the development of secondary FSGS. Because birth history is often not obtained by adult nephrologists, this risk factor is likely to be underrecognized.

Related Articles

Developmental Origins of Renal Disease: Should Nephron Protection Begin at Birth?

Susan P. Bagby
Clin. J. Am. Soc. Nephrol. 2009 4: 10-13. [Full Text] [PDF]

This article has been cited by other articles:

				S. P. Bagby Developmental Origins of Renal Disease: Should Nephron Protection Begin at Birth? Clin. J. Am. Soc. Nephrol., January 1, 2009; 4(1): 10 - 13. [Full Text] [PDF]