Lav fødselsvægt - Øget risiko for diabetisk nefropati?

It has been demonstrated that intrauterine growth retardation gives rise to a reduction in nephron number. Oligonephropathy has been suggested to enhance the risk for expression of renal disease following exposure to potentially injurious renal stimuli. In a case-control study we investigated if low birth weight is a risk factor for development of diabetic nephropathy in 184 IDDM patients with diabetic nephropathy (persistent albuminuria >300 mg/24 hours) and 182 normoalbuminuric (<30 mg/24 hours) patients. In women with birthweight <10 th centile (≤2,700 g, n=16) 75 % had nephropathy compared to only 35% among patients >90 th centile (≥4,000 g, n=17) (p=0.05). In men with birthweight <10th centile (≤2,910 g, n=22) the prevalence of nephropathy: 50%, was similar to the prevalence among patients >90th centile (≥4,200 g, n=24) 54%. Mean weight at birth were similar in patients with and without diabetic nephropathy. Men with diabetic nephropathy were significantly shorter than men with normoalbuminuria (176.9 (7.1) vs 179.4 (6.5), p<0,01). In conclusion, our study supports the hypothesis that genetic predisposition or factors operating in utero or early childhood, or both, contribute to the development of diabetic nephropathy.