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Gepubliceerd in:

01-04-2002 | Artikelen

Laag geboortegewicht: consequenties voor de nier?

Auteurs: M. F. Schreuder, M. Fodor, J. A. E. van Wijk, H. A. Delemarre-van de Waal

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 5/2002

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Samenvatting

De laatste jaren is er bewijs geleverd voor een relatie tussen een laag geboortegewicht en een toegenomen risico op aandoeningen op latere leeftijd, zoals hypertensie, hart- en vaatziekten en diabetes mellitus type II. Oorzakelijk dient gedacht te worden aan intra-uteriene groeivertraging, hetgeen interfereert met de aanleg en functie van organen (herprogrammering genoemd).
Uit onderzoek bij de mens en diverse proefdiermodellen blijkt herprogrammering van de nier voor een afgenomen hoeveelheid nefronen te zorgen. Ter compensatie treedt er in de aanwezige nefronen hyperfiltratie op, leidend tot glomerulaire en systemische hypertensie en glomerulosclerose, met als eindpunt nierinsufficiëntie. Door het verminderde aantal nefronen zijn de nieren kwetsbaarder; in het geval van bijkomende renale aandoeningen lijkt de prognose slechter te zijn bij een laag geboortegewicht.
De rol van het renine-angiotensine-systeem (ras) is belangrijk gezien de invloed ervan op de renale hemodynamiek, die veranderd is bij een laag geboortegewicht. Uit proefdieronderzoek lijkt het ras een aangrijpingspunt te bieden voor medicamenteuze manipulatie van de gevolgen van een laag geboortegewicht. Aanvullende gegevens zijn echter noodzakelijk om tot klinische implicaties te komen.
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Metagegevens
Titel
Laag geboortegewicht: consequenties voor de nier?
Auteurs
M. F. Schreuder
M. Fodor
J. A. E. van Wijk
H. A. Delemarre-van de Waal
Publicatiedatum
01-04-2002
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Kindergeneeskunde / Uitgave 5/2002
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI
https://doi.org/10.1007/BF03061371