Dr. J. Bryan Carmody became interested in prematurity and chronic kidney disease after a few former preemies came to the clinic with significant chronic kidney disease. These children were going to need either dialysis or a transplant in the near future. “Getting that diagnosis,” says Dr. Carmody, “is very shocking to parents, and we wondered whether we should have been following these kids all along, from the time they left the NICU.” Dr. Carmody and Dr. Jennifer R. Charlton saw this as an opportunity to present the evidence for that argument to the broader pediatrics community. They recently achieved that goal with their publication of “Short-Term Gestation, Long-Term Risk: Prematurity and Chronic Kidney Disease” in Pediatrics.
The article focuses on “theory, experimental evidence, and observational data that suggest an increased risk of chronic kidney disease for infants born prematurely.” Children born prematurely or with low birth weight do not have a complete complement of nephrons, a problem that can be exacerbated by external stressors and which, along with other factors, can lead to chronic kidney disease.
Dr. Carmody said that while he saw evidence of the correlation between premature birth and chronic kidney disease piling up in clinical and basic science data, he didn’t have “the ‘gold standard’ of evidence to base follow-up recommendations on.” Still, he and Dr. Charlton felt that their observations would be valuable to other doctors. The article, he says, is the beginning of a conversation. “Whether readers agree with our follow-up recommendation or not, I think that our review is going to get people thinking,” says Dr. Carmody. You can read the entire article by Dr. Carmody and Dr. Charlton here.
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