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However, concerns persist regarding the long-term kidney implications of prematurity. Nephrogenesis is disrupted, particularly in those born very preterm (\u2264\u200932\u00a0weeks of gestation), increasing the risk of early kidney dysfunction and hypertension later in life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis aimed to evaluate kidney health outcomes in former very preterm children and adolescents compared to full-term peers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>A systematic literature search was conducted in MEDLINE\/PubMed, Scopus, and Web of Science from their earliest available records to October 9, 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study eligibility criteria<\/jats:title>\n                    <jats:p>We included observational studies comparing kidney health parameters between children\/adolescents born very preterm (gestational age \u2013 GA\u2009\u2264\u200932\u00a0weeks) and their full-term counterparts (gestational age\u2009&gt;\u200936\u00a0weeks or birth weight\u2009&gt;\u20092000\u00a0g) within the age range of 6 to 18\u00a0years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and interventions<\/jats:title>\n                    <jats:p>Children and adolescents aged 6\u201318\u00a0years born very preterm were compared to their full-term counterparts. The analyzed kidney function markers included serum Cystatin C, serum creatinine (sCr), estimated glomerular filtration rate (eGFR) based on sCr (Cr-eGFR), and blood pressure (systolic and diastolic, SBP\/DBP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study appraisal and synthesis methods<\/jats:title>\n                    <jats:p>\n                      The Newcastle\u2013Ottawa Scale was used to assess study quality. The mean difference with 95% confidence intervals was used for continuous outcomes. Statistical significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05. Sensitivity, subgroup and meta-regression analyses were conducted for further exploration of the outcomes. Statistical analyses were performed using R software (Version 4.3.2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies (16 reports; 2,112 participants) were included. Very preterm children and adolescents had higher serum Cystatin C (0.05\u00a0mg\/L; 95%CI: 0.02\u20130.08), lower Cr-eGFR (-11.87\u00a0mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ; 95%CI: -22.44 to -1.31), and higher SBP (1.96\u00a0mmHg; 95%CI: 0.21\u20133.71). Sensitivity analysis confirmed Cystatin C findings but rendered Cr-eGFR and SBP differences non-significant. Subgroup analysis showed a significant GA effect on sCr (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), though the\u2009\u2265\u200928\u00a0weeks subgroup included only two studies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations<\/jats:title>\n                    <jats:p>Considerable heterogeneity across studies persisted despite sensitivity and subgroup analyses. The lack of randomized controlled trials and longitudinal studies limits result interpretation, while non-significant meta-regression findings hinder full explanation of heterogeneity. Insufficient data prevented the assessment of additional kidney function parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and implications of key findings<\/jats:title>\n                    <jats:p>Cystatin C was elevated in very preterm individuals compared to full-term peers, reinforcing its role as an early marker of kidney dysfunction. While differences in Cr-eGFR and SBP lost significance after sensitivity analysis, these markers remain relevant for long-term follow-up in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration number<\/jats:title>\n                    <jats:p>PROSPERO (CRD42024554702).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-025-06797-z","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T10:50:40Z","timestamp":1748256640000},"page":"61-72","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Kidney health outcomes in children born very prematurely compared to full-term counterparts: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-7929","authenticated-orcid":false,"given":"Vaia","family":"Dokousli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5450-8313","authenticated-orcid":false,"given":"Anastasia","family":"Stoimeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8348-8520","authenticated-orcid":false,"given":"Nikolaos","family":"Gkiourtzis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7108-7663","authenticated-orcid":false,"given":"Despoina","family":"Samourkasidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Karatisidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9084-7760","authenticated-orcid":false,"given":"Nikolaos","family":"Charitakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2718-7480","authenticated-orcid":false,"given":"Kali","family":"Makedou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0376-1011","authenticated-orcid":false,"given":"Christos","family":"Tsakalidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4350-9061","authenticated-orcid":false,"given":"George","family":"Koliakos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0085-7384","authenticated-orcid":false,"given":"Despoina","family":"Tramma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"6797_CR1","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/S0140-6736(23)00878-4","volume":"402","author":"EO Ohuma","year":"2023","unstructured":"Ohuma EO, Moller A-B, Bradley E et al (2023) National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. 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