Renal Consequences of Therapeutic Interventions in Premature Neonates

Nephron. 2019;142(2):117-124. doi: 10.1159/000497162. Epub 2019 Feb 6.

Abstract

An infant is described as "preterm" if they are born before 37 weeks of gestation. As nephrogenesis does not complete until 36 weeks of gestation, premature infants are often born with underdeveloped kidneys. Current evidence strongly suggests that this leaves those born prematurely more susceptible to developing kidney-related conditions later in life. Although the incidence of premature birth steadily increases each year in the United Kingdom, reports of perinatal death following preterm labour are falling. This is mainly attributed to the development of antenatal drugs, such as tocolytics, corticosteroids and antibiotics. Though these drugs have effectively reduced the incidence of premature-birth-related deaths, evidence suggests that they may be nephrotoxic. This review will describe the experimental evidence that some therapeutics are disadvantageous to kidney functions later on in life.

Keywords: Angiotensin-converting enzyme; Antibiotics; Corticosteroids; Kidney disease; Preterm birth; Tocolytics.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / adverse effects*
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Kidney / growth & development
  • Kidney / physiopathology*
  • Tocolytic Agents / adverse effects*
  • United Kingdom

Substances

  • Adrenal Cortex Hormones
  • Angiotensin-Converting Enzyme Inhibitors
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Tocolytic Agents