Kidney health outcomes in children born very prematurely compared to full-term counterparts: a systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis compared kidney health in children and adolescents aged 6–18 years born very preterm (≤32 weeks’ gestation) with full-term peers. It included 13 observational studies (16 reports; 2,112 participants). Very preterm participants had higher serum cystatin C by 0.05 mg/L (95% CI, 0.02–0.08), lower creatinine-based eGFR, and higher systolic blood pressure. Sensitivity analyses confirmed the cystatin C difference but rendered the eGFR and blood-pressure differences non-significant, making cystatin C the most robust finding.

Key findings

• Serum cystatin C was higher by 0.05 mg/L (95% CI: 0.02-0.08) in very preterm children and adolescents.
• Creatinine-based eGFR was lower by -11.87 mL/min/1.73 m 2 (95%CI: -22.44 to -1.31), but the difference was non-significant in sensitivity analysis.
• Systolic blood pressure was higher by 1.96 mmHg (95%CI: 0.21-3.71), but the difference was non-significant in sensitivity analysis.
• Subgroup analysis found a gestational-age effect on serum creatinine (p < 0.0001); the ≥28-week subgroup included only two studies.

Why it matters

The findings suggest that kidney-related differences may be detectable during childhood after very preterm birth, with cystatin C showing the most consistent association in this review. This supports attention to kidney health in this population, while the sensitivity of other results to analysis choices and the heterogeneity across studies mean that the magnitude and clinical implications of differences remain uncertain.

What to keep in mind

Considerable heterogeneity persisted. The evidence comprised observational studies, with no randomized controlled trials or longitudinal studies; non-significant meta-regression findings limited explanation of heterogeneity, and data were insufficient for additional kidney parameters.