Skip to main content
SpringerLink
Log in

Cystic dysplasia of the kidneys in extremely preterm infants following acute kidney injury

  • Brief Report
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Various perinatal morbidities may adversely affect postnatal nephrogenesis in preterm infants. Kidney ultrasonographic findings following acute kidney injury (AKI) have not been well described in preterm infants. Herein, we describe three cases of extremely preterm infants who showed abnormal kidney ultrasonographic findings resembling dysplasia of the kidneys following AKI.

Case-diagnosis/treatment

Their median gestational age and birth weight were 25+6 (range 23+3–26+6) weeks and 620 (480–840) g, respectively. All infants suffered severe AKI during their third to seventh week of life. Their kidney function recovered with conventional management. Kidney ultrasonographies performed after AKI revealed increased kidney echogenicity, loss of corticomedullary differentiation, and multiple cortical cysts, which were similar to cystic dysplasia of the kidneys and were absent in previous kidney imaging. Three infants eventually developed at least one of the long-term kidney sequelae following AKI, including proteinuria, hypertension, and elevated levels of serum creatinine or cystatin C as determined during the last follow-up at the corrected age of 9–18 months.

Conclusions

Based on these cases, we can infer that AKI occurring during the early postnatal period may result in dysplasia of the kidneys with cortical cysts in extremely preterm infants, which may lead to chronic kidney disease in their later life. It is useful to follow up not only laboratory parameters but also kidney ultrasonographic findings in extremely preterm infants who suffered AKI during their early postnatal periods.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

All data and material generated or analyzed during this study are included in this published article.

References

  1. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, Chishti AS, Woroniecki R, Mammen C, Swanson JR, Sridhar S, Wong CS, Kupferman JC, Griffin RL, Askenazi DJ, Neonatal Kidney Collaborative (NKC) (2017) Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health 1:184–194

    Article  PubMed Central  Google Scholar 

  2. Carmody JB, Swanson JR, Rhone ET, Charlton JR (2014) Recognition and reporting of AKI in very low birth weight infants. Clin J Am Soc Nephrol 9:2036–2043

    Article  PubMed Central  Google Scholar 

  3. Stojanovic V, Barisic N, Milanovic B, Doronjski A (2014) Acute kidney injury in preterm infants admitted to a neonatal intensive care unit. Pediatr Nephrol 29:2213–2220

    Article  PubMed Central  Google Scholar 

  4. Abitbol CL, Bauer CR, Montane B, Chandar J, Duara S, Zilleruelo G (2003) Long-term follow-up of extremely low birth weight infants with neonatal renal failure. Pediatr Nephrol 18:887–893

    Article  PubMed Central  Google Scholar 

  5. Chevalier RL (1996) Developmental renal physiology of the low birth weight pre-term newborn. J Urol 156:714–719

    Article  CAS  Google Scholar 

  6. Sutherland MR, Gubhaju L, Moore L, Kent AL, Dahlstrom JE, Horne RS, Hoy WE, Bertram JF, Black MJ (2011) Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol 22:1365–1374

    Article  PubMed Central  Google Scholar 

  7. Rosenblum S, Pal A, Reidy K (2017) Renal development in the fetus and premature infant. Semin Fetal Neonatal Med 22:58–66

    Article  PubMed Central  Google Scholar 

  8. Riccabona MJUC (2006) Renal failure in neonates, infants, and children: the role of ultrasound 1:457-469

  9. Abitbol CL, DeFreitas MJ, Strauss J (2016) Assessment of kidney function in preterm infants: lifelong implications. Pediatr Nephrol 31:2213–2222

    Article  Google Scholar 

  10. Abitbol CL, Seeherunvong W, Galarza MG, Katsoufis C, Francoeur D, Defreitas M, Edwards-Richards A, Master Sankar Raj V, Chandar J, Duara S, Yasin S, Zilleruelo G (2014) Neonatal kidney size and function in preterm infants: what is a true estimate of glomerular filtration rate? J Pediatr 164(1026–1031):e1022

    Google Scholar 

  11. Crump C, Sundquist J, Winkleby MA, Sundquist K (2019) Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood: national cohort study. BMJ 365:l1346

    Article  PubMed Central  Google Scholar 

  12. Rodriguez MM, Gomez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25

    Article  Google Scholar 

  13. Chaturvedi S, Ng KH, Mammen C (2017) The path to chronic kidney disease following acute kidney injury: a neonatal perspective. Pediatr Nephrol 32:227–241

    Article  Google Scholar 

  14. Greenbaum LA, Munoz A, Schneider MF, Kaskel FJ, Askenazi DJ, Jenkins R, Hotchkiss H, Moxey-Mims M, Furth SL, Warady BA (2011) The association between abnormal birth history and growth in children with CKD. Clin J Am Soc Nephrol 6:14–21

    Article  PubMed Central  Google Scholar 

  15. Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, Askenazi DJ, Kent AL (2015) Neonatal acute kidney injury. Pediatrics 136:e463–e473

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Seh Hyun Kim, Yo Han Ahn, Jeongmin Shin, Young Hwa Jung & Chang Won Choi

  2. Department of Pediatrics, Seoul National University Children’s Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Yo Han Ahn

  3. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea

    Chang Won Choi

  4. Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    Ji Young Kim

Authors
  1. Seh Hyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yo Han Ahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeongmin Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young Hwa Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ji Young Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chang Won Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Seh Hyun Kim and Yo Han Ahn. The first draft of the manuscript was written by Seh Hyun Kim, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yo Han Ahn.

Ethics declarations

Conflicts of interest

The authors declare that they have no competing interests.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of the Seoul National University Bundang Hospital (IRB No. B-1912/580-701).

Consent to participate

Informed consent to participate in the study was obtained from parents of the participants.

Consent for publication

Parents of patients signed informed consent regarding publication of the data.

Code availability

Not applicable

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, S.H., Ahn, Y.H., Shin, J. et al. Cystic dysplasia of the kidneys in extremely preterm infants following acute kidney injury. Pediatr Nephrol 35, 2369–2372 (2020). https://doi.org/10.1007/s00467-020-04737-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-020-04737-7

Keywords

Search

Navigation