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Early postnatal nutrition and renal consequences in preterm infants

Pediatric Research (2024)Cite this article

Abstract

Perinatal nutritional factors may lead to decreased nephron endowment, decreased kidney function, and long-term development of chronic kidney disease and non-communicable diseases. At the same time, optimal postnatal nutrition and catch-up growth are associated with better neurodevelopmental outcomes in preterm infants. Therefore, nutritional management of preterm infants is a major challenge for neonatologists. In this context, the Section of Nutrition, Gastroenterology and Metabolism reviewed the current knowledge on nutritional issues related to kidney function. This narrative review discusses the clinical impact of early postnatal nutrition on long-term kidney function. In preterm infants, data are largely lacking to determine the extent to which early nutrition contributes to nephrogenesis and nephron endowment. However, some nutritional principles may help clinicians better protect the developing kidney in preterm infants.

Impact

  • Clinical data show that preterm infants are an emerging population at high risk for chronic kidney disease.

  • Both undernutrition and overnutrition can alter long-term kidney function.

  • In preterm infants, data are largely lacking to determine the extent to which early postnatal nutrition contributes to nephrogenesis, nephron endowment and increased risk for chronic kidney disease.

  • Some nutritional principles may help clinicians better protect the developing kidney in preterm infants: avoiding extrauterine growth restriction; providing adequate protein and caloric intakes; limiting exposure to high and prolonged hyperglycaemia; avoiding micronutrient deficiencies and maintaining acid-base and electrolyte balance.

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Acknowledgements

We dedicate this paper to our teachers. Our special thank is addressed to Professor Jean-Pierre Guignard.

Author information

Authors and Affiliations

  1. Réanimation Néonatale et Pédiatrique, CHU La Réunion, Saint-Pierre, France

    Silvia Iacobelli

  2. Centre d’Études Périnatales de l’Océan Indien (UR7388), Université de La Réunion, de La Réunion, France

    Silvia Iacobelli

  3. Department of Neonatology, APHP, Necker-Enfants Malades University Hospital, EHU 7328 Paris Cite University Paris, Paris, France

    Alexandre Lapillonne

  4. CNRC Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Alexandre Lapillonne

  5. Service de Médecine néonatale, CHU La Conception, APHM, Marseille, France

    Farid Boubred

  6. Aix-Marseille Université, C2VN, INRAe, INSERM, Marseille, France

    Farid Boubred

  7. Department of Pediatrics, McMaster University, Hamilton, ON, Canada

    Christoph Fusch

  8. Department of Pediatrics, Nuremberg General Hospital, Paracelsus Medical School, Nuremberg, Germany

    Christoph Fusch

  9. Department of Neonatal Medicine, National Institute for Health Research Biomedical Research Centre Southampton, University Hospital Southampton NHS Trust and University of Southampton, Southampton, UK

    Mark J. Johnson

  10. Division of Paediatric and Adolescent Medicine, Department of Neonatal Intensive Care, Ullevål, Oslo University Hospital, Oslo, Norway

    Sissel J. Moltu

  11. Neonatology, Instituto de Investigación Sanitaria del Hospital Universitario La Paz – IdiPAZ, (La Paz University Hospital – Universidad Autónoma de Madrid), Madrid, Spain

    Miguel Saenz de Pipaon

  12. Hans Christian Andersen Children’s Hospital, Department of Neonatology, Odense University Hospital, and Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark

    Gitte Zachariassen

Authors
  1. Silvia Iacobelli
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  2. Alexandre Lapillonne
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  3. Farid Boubred
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Consortia

ESPR Nutrition council members

  • Christoph Fusch
  • , Silvia Iacobelli
  • , Mark J. Johnson
  • , Alexandre Lapillonne
  • , Sissel J. Moltu
  • , Miguel Saenz de Pipaon
  •  & Gitte Zachariassen

Contributions

Silvia Iacobelli and Farid Boubred have equally contributed to this manuscript. Alexandre Lapillonne provided important scientific contribution. All authors and all the members of the ESPR Nutrition council reviewed or approved the final manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

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Correspondence to Silvia Iacobelli.

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Iacobelli, S., Lapillonne, A., Boubred, F. et al. Early postnatal nutrition and renal consequences in preterm infants. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03080-z

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