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  1. Artikel ; Online: Hypotension: a modifiable risk factor impacting surgical NEC-associated AKI and brain injury in preterm infants.

    Garg, Parvesh Mohan / South, Andrew M / Inder, Terrie / Shenberger, Jeffrey S

    Pediatric research

    2024  

    Sprache Englisch
    Erscheinungsdatum 2024-05-07
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-024-03244-x
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  2. Artikel ; Online: Antenatal Programming of Hypertension: Paradigms, Paradoxes, and How We Move Forward.

    South, Andrew M / Allen, Norrina B

    Current hypertension reports

    2022  Band 24, Heft 12, Seite(n) 655–667

    Abstract: Purpose of review: Synthesize the clinical, epidemiological, and preclinical evidence for antenatal programming of hypertension and critically appraise paradigms and paradoxes to improve translation.: Recent findings: Clinical and epidemiological ... ...

    Abstract Purpose of review: Synthesize the clinical, epidemiological, and preclinical evidence for antenatal programming of hypertension and critically appraise paradigms and paradoxes to improve translation.
    Recent findings: Clinical and epidemiological studies persistently demonstrate that antenatal factors contribute to programmed hypertension under the developmental origins of health and disease framework, including lower birth weight, preterm birth, and fetal growth restriction. Preclinical mechanisms include preeclampsia, maternal diabetes, maternal undernutrition, and antenatal corticosteroid exposure. However, clinical and epidemiological studies to date have largely failed to adequately identify, discuss, and mitigate many sources and types of bias in part due to heterogeneous study designs and incomplete adherence to scientific rigor. These limitations have led to incomplete and biased paradigms as well as persistent paradoxes that have significantly limited translation into clinical and population health interventions. Improved understanding of these paradigms and paradoxes will allow us to substantially move the field forward.
    Mesh-Begriff(e) Infant, Newborn ; Pregnancy ; Female ; Humans ; Premature Birth/epidemiology ; Hypertension/epidemiology ; Pre-Eclampsia ; Adrenal Cortex Hormones ; Fetal Growth Retardation
    Chemische Substanzen Adrenal Cortex Hormones
    Sprache Englisch
    Erscheinungsdatum 2022-10-13
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 2057367-4
    ISSN 1534-3111 ; 1522-6417
    ISSN (online) 1534-3111
    ISSN 1522-6417
    DOI 10.1007/s11906-022-01227-z
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  3. Artikel ; Online: Correlation between kidney sodium and potassium handling and the renin-angiotensin-aldosterone system in children with hypertensive disorders.

    Perrin, Ella C / South, Andrew M

    Pediatric nephrology (Berlin, Germany)

    2021  Band 37, Heft 3, Seite(n) 633–641

    Abstract: Background: Urine sodium and potassium are used as surrogate markers for dietary consumption in adults with hypertension, but their role in youth with hypertension and their association with components of the renin-angiotensin-aldosterone system (RAAS) ... ...

    Abstract Background: Urine sodium and potassium are used as surrogate markers for dietary consumption in adults with hypertension, but their role in youth with hypertension and their association with components of the renin-angiotensin-aldosterone system (RAAS) are incompletely characterized. Some individuals with hypertension may have an abnormal RAAS response to dietary sodium and potassium intake, though this is incompletely described. Our objective was to investigate if plasma renin activity and serum aldosterone are associated with urine sodium and potassium in youth referred for hypertensive disorders.
    Methods: This pilot study was a cross-sectional analysis of baseline data from 44 youth evaluated for hypertensive disorders in a Hypertension Clinic. We recorded urine sodium and potassium concentrations normalized to urine creatinine, plasma renin activity, and serum aldosterone and calculated the sodium/potassium (UNaK) and aldosterone/renin ratios. We used multivariable generalized linear models to estimate the associations of renin and aldosterone with urine sodium and potassium.
    Results: Our cohort was diverse (37% non-Hispanic Black, 14% Hispanic), 66% were male, and median age was 15.3 years; 77% had obesity and 9% had a secondary etiology. Aldosterone was associated inversely with urine sodium/creatinine (β: -0.34, 95% CI -0.62 to -0.06) and UNaK (β: -0.09, 95% CI -0.16 to -0.03), and adjusted for estimated glomerular filtration rate and serum potassium.
    Conclusions: Higher serum aldosterone levels, but not plasma renin activity, were associated with lower urine sodium/creatinine and UNaK at baseline in youth referred for hypertensive disorders. Further characterization of the RAAS could help define hypertension phenotypes and guide management. A higher resolution version of the Graphical abstract is available as supplementary information.
    Mesh-Begriff(e) Adolescent ; Aldosterone ; Blood Pressure/physiology ; Creatinine/metabolism ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Kidney ; Male ; Pilot Projects ; Potassium ; Pregnancy ; Renin ; Renin-Angiotensin System/physiology ; Sodium
    Chemische Substanzen Aldosterone (4964P6T9RB) ; Sodium (9NEZ333N27) ; Creatinine (AYI8EX34EU) ; Renin (EC 3.4.23.15) ; Potassium (RWP5GA015D)
    Sprache Englisch
    Erscheinungsdatum 2021-09-09
    Erscheinungsland Germany
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-021-05204-7
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  4. Artikel ; Online: Prevalence and risk factors of disordered eating behavior in youth with hypertension disorders.

    Perrin, Ella C / Ravi, Hanna L / Borra, Gagana S / South, Andrew M

    Pediatric nephrology (Berlin, Germany)

    2023  Band 38, Heft 11, Seite(n) 3779–3789

    Abstract: Background: Adolescents with certain health conditions requiring lifestyle management, such as diabetes mellitus, have higher disordered eating behavior (DEB) risk than the general adolescent population, but DEB is underdiagnosed and can lead to adverse ...

    Abstract Background: Adolescents with certain health conditions requiring lifestyle management, such as diabetes mellitus, have higher disordered eating behavior (DEB) risk than the general adolescent population, but DEB is underdiagnosed and can lead to adverse health consequences. In youth with other conditions requiring lifestyle counseling such as hypertension (HTN), DEB prevalence and associated risk factors are unknown. We hypothesized that youth with HTN disorders would have higher DEB prevalence than the general adolescent population, and that obesity, chronic kidney disease (CKD), and less specialized lifestyle counseling would be associated with higher DEB risk.
    Methods: Prospective cross-sectional study of youth aged 11-18 years with HTN disorders. We excluded patients with diabetes mellitus, kidney failure or transplantation, or gastrostomy tube dependence. We collected data via surveys and electronic health record abstraction. We administered the validated SCOFF DEB screening questionnaire. We compared DEB prevalence using a one-sample z-test of proportions (p
    Results: Of 74 participants, 59% identified as male, 22% as Black or African American, and 36% as Hispanic or Latino; 58% had obesity and 26% had CKD. DEB prevalence was 28% (95% CI 18-39%, p < 0.001). CKD was associated with higher DEB prevalence (adjusted RR 2.17, 95% CL 1.09 to 4.32), but obesity and lifestyle counseling source were not.
    Conclusions: DEB prevalence is higher in youth with HTN disorders and comparable to other conditions requiring lifestyle counseling. Youth with HTN disorders may benefit from DEB screening. A higher resolution version of the Graphical abstract is available as Supplementary information.
    Mesh-Begriff(e) Humans ; Male ; Adolescent ; Diabetes Mellitus, Type 1/complications ; Prospective Studies ; Prevalence ; Cross-Sectional Studies ; Risk Factors ; Hypertension/epidemiology ; Hypertension/complications ; Obesity/complications ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/complications ; Feeding and Eating Disorders
    Sprache Englisch
    Erscheinungsdatum 2023-05-17
    Erscheinungsland Germany
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 631932-4
    ISSN 1432-198X ; 0931-041X
    ISSN (online) 1432-198X
    ISSN 0931-041X
    DOI 10.1007/s00467-023-05921-1
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  5. Artikel ; Online: Management of acute severe hypertension in youth: from the philosophical to the practical.

    Giammattei, Victoria C / Weaver, Donald J / South, Andrew M

    Current opinion in pediatrics

    2022  Band 35, Heft 2, Seite(n) 251–258

    Abstract: Purpose of review: Acute severe hypertension remains an uncommon but important source of morbidity and mortality in youth. However, there has been very little progress made in our understanding of how to best manage youth with acute severe hypertension ... ...

    Abstract Purpose of review: Acute severe hypertension remains an uncommon but important source of morbidity and mortality in youth. However, there has been very little progress made in our understanding of how to best manage youth with acute severe hypertension to improve patient outcomes.
    Recent findings: Our understanding of what is acute severe hypertension is undergoing a philosophical change. Management of patients with acute severe hypertension is evolving towards more of a risk and outcomes-based approach.
    Summary: We should be intentional when we consider whether a patient has acute severe hypertension and if they are truly at an increased risk for life-threatening target organ injury. We should consider their specific risk factors to best interpret the risks and benefits of how best to treat a patient with acute severe hypertension, rather than relying on traditional approaches and conventional wisdom. We should always ask 'why' when we are pursuing a given management course. Future studies should clearly define the research questions they are investigating to best advance the field to ultimately improve patient outcomes.
    Mesh-Begriff(e) Humans ; Adolescent ; Risk Factors ; Forecasting ; Hypertension/diagnosis ; Hypertension/therapy
    Sprache Englisch
    Erscheinungsdatum 2022-11-25
    Erscheinungsland United States
    Dokumenttyp Review ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1049374-8
    ISSN 1531-698X ; 1040-8703
    ISSN (online) 1531-698X
    ISSN 1040-8703
    DOI 10.1097/MOP.0000000000001209
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Risk of Obesity and Unhealthy Central Adiposity in Adolescents Born Preterm With Very Low Birthweight Compared to Term-Born Peers.

    Brouwer, Ellen Corina Jacoba / Floyd, Whitney N / Jensen, Elizabeth T / O'Connell, Nathaniel / Shaltout, Hossam A / Washburn, Lisa K / South, Andrew M

    Childhood obesity (Print)

    2024  

    Abstract: Background: ...

    Abstract Background:
    Sprache Englisch
    Erscheinungsdatum 2024-02-22
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2639910-6
    ISSN 2153-2176 ; 2153-2168
    ISSN (online) 2153-2176
    ISSN 2153-2168
    DOI 10.1089/chi.2023.0115
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  7. Artikel: Association of kidney function with posterior reversible encephalopathy syndrome in children.

    Shah, Shruti M / South, Andrew M

    Clinical nephrology

    2020  Band 98, Heft 1, Seite(n) 10–15

    Abstract: Aims: Investigate if kidney function markers predict posterior reversible encephalopathy syndrome (PRES) in children.: Materials and methods: In a case-control study of high-risk children with confirmed PRES (n = 35) compared to controls (n = 14), we ...

    Abstract Aims: Investigate if kidney function markers predict posterior reversible encephalopathy syndrome (PRES) in children.
    Materials and methods: In a case-control study of high-risk children with confirmed PRES (n = 35) compared to controls (n = 14), we recorded blood urea nitrogen (BUN), serum creatinine, serum albumin, hemoglobin concentrations, estimated glomerular filtration rate, and documentation of acute kidney injury (AKI). We applied multivariable regression models and determined receiver operating characteristic curves.
    Results: Mean age was 9.5 (SD 4.9) years, 51% were female, 29% had chronic kidney disease, 67% had nephrotoxic medication exposure, and 29% had AKI. A 1-mg/dL increase in BUN (adjusted OR 1.03, 95% CI 0.99 - 1.07) and AKI (adjusted OR 3.78, 0.68 - 21.13) were minimally, but not statistically significantly, associated with PRES. BUN = 21.6 mg/dL performed best but had low ability to predict PRES (area under the curve 0.664, 0.498 - 0.831), with 60.0% sensitivity, 71.4% specificity, and positive and negative predictive values of 84.0% and 41.7%, respectively.
    Conclusion: Kidney function may be a relatively more minor risk factor for PRES than previously believed. Further prospective studies with larger sample sizes and better kidney function assessments are warranted to evaluate the role of kidney function in the development of PRES.
    Mesh-Begriff(e) Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Adolescent ; Biomarkers ; Case-Control Studies ; Child ; Child, Preschool ; Creatinine ; Female ; Humans ; Kidney ; Male ; Posterior Leukoencephalopathy Syndrome/complications ; Posterior Leukoencephalopathy Syndrome/etiology ; Prospective Studies
    Chemische Substanzen Biomarkers ; Creatinine (AYI8EX34EU)
    Sprache Englisch
    Erscheinungsdatum 2020-12-10
    Erscheinungsland Germany
    Dokumenttyp Journal Article
    ZDB-ID 185101-9
    ISSN 0301-0430
    ISSN 0301-0430
    DOI 10.5414/CN110706
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight.

    Floyd, Whitney N / Beavers, Daniel P / Jensen, Elizabeth T / Washburn, Lisa K / South, Andrew M

    Journal of perinatology : official journal of the California Perinatal Association

    2023  Band 43, Heft 8, Seite(n) 1038–1044

    Abstract: ... ml/min/1.73 m: Conclusion: ANCS exposure was not associated with worse kidney function ...

    Abstract Objective: Investigate if antenatal corticosteroids (ANCS) are associated with worse kidney function in adolescence and if greater adiposity magnifies this association.
    Study design: Prospective cohort of 162 14-year-olds born preterm with very low birth weight (<1500 g). Outcomes were estimated glomerular filtration rate (eGFR) and first-morning urine albumin-to-creatinine ratio (UACR). We used adjusted generalized linear models, stratified by waist-to-height ratio (WHR) ≥ 0.5.
    Results: Fifty-five percent had ANCS exposure and 31.3% had WHR ≥ 0.5. In adjusted analyses of the entire cohort, ANCS was not significantly associated with eGFR or UACR. However, the ANCS-eGFR association was greater in those with WHR ≥ 0.5 (β -16.8 ml/min/1.73 m
    Conclusion: ANCS exposure was not associated with worse kidney function in adolescence, though ANCS may be associated with lower eGFR if children develop obesity by adolescence.
    Mesh-Begriff(e) Infant, Newborn ; Child ; Humans ; Female ; Adolescent ; Pregnancy ; Prospective Studies ; Creatinine ; Infant, Very Low Birth Weight ; Obesity ; Glomerular Filtration Rate ; Kidney ; Adrenal Cortex Hormones/adverse effects
    Chemische Substanzen Creatinine (AYI8EX34EU) ; Adrenal Cortex Hormones
    Sprache Englisch
    Erscheinungsdatum 2023-05-09
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 645021-0
    ISSN 1476-5543 ; 0743-8346
    ISSN (online) 1476-5543
    ISSN 0743-8346
    DOI 10.1038/s41372-023-01688-3
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  9. Artikel ; Online: The role of preterm birth in stress-induced sodium excretion in young adults.

    Tully, Nicholas W / Chappell, Mark C / Evans, Joni K / Jensen, Elizabeth T / Shaltout, Hossam A / Washburn, Lisa K / South, Andrew M

    Journal of hypertension

    2024  Band 42, Heft 6, Seite(n) 1086–1093

    Abstract: Background: Early-life programming due to prematurity and very low birth weight (VLBW, <1500 g) is believed to contribute to development of hypertension, but the mechanisms remain unclear. Experimental data suggest that altered pressure natriuresis ( ... ...

    Abstract Background: Early-life programming due to prematurity and very low birth weight (VLBW, <1500 g) is believed to contribute to development of hypertension, but the mechanisms remain unclear. Experimental data suggest that altered pressure natriuresis (increased renal perfusion pressure promoting sodium excretion) may be a contributing mechanism. We hypothesize that young adults born preterm will have a blunted pressure natriuresis response to mental stress compared with those born term.
    Methods: In this prospective cohort study of 190 individuals aged 18-23 years, 156 born preterm with VLBW and 34 controls born term with birth weight at least 2500 g, we measured urine sodium/creatinine before and after a mental stress test and continuous blood pressure before and during the stress test. Participants were stratified into groups by the trajectory at which mean arterial pressure (MAP) increased following the test. The group with the lowest MAP trajectory was the reference group. We used generalized linear models to assess poststress urine sodium/creatinine relative to the change in MAP trajectory and assessed the difference between groups by preterm birth status.
    Results: Participants' mean age was 19.8 years and 57% were women. Change in urine sodium/creatinine per unit increase in MAP when comparing middle trajectory group against the reference group was greater in those born preterm [β 5.4%, 95% confidence interval (95% CI) -11.4 to 5.3] than those born term (β 38.5%, 95% CI -0.04 to 92.0), interaction term P = 0.002.
    Conclusion: We observed that, as blood pressure increased following mental stress, young adults born preterm exhibited decreased sodium excretion relative to term-born individuals.
    Mesh-Begriff(e) Humans ; Female ; Male ; Young Adult ; Stress, Psychological/physiopathology ; Stress, Psychological/urine ; Adolescent ; Sodium/urine ; Prospective Studies ; Premature Birth/physiopathology ; Blood Pressure/physiology ; Infant, Newborn ; Creatinine/urine ; Adult ; Natriuresis
    Chemische Substanzen Sodium (9NEZ333N27) ; Creatinine (AYI8EX34EU)
    Sprache Englisch
    Erscheinungsdatum 2024-02-28
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 605532-1
    ISSN 1473-5598 ; 0263-6352 ; 0952-1178
    ISSN (online) 1473-5598
    ISSN 0263-6352 ; 0952-1178
    DOI 10.1097/HJH.0000000000003705
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  10. Artikel ; Online: Duration of Simultaneous Exposure to High-Risk and Lower-Risk Nephrotoxic Antimicrobials in the Neonatal Intensive Care Unit (NICU) and Future Adolescent Kidney Health.

    Schiff, Andrew F / Deines, Danielle / Jensen, Elizabeth T / O'Connell, Nathaniel / Perry, Courtney J / Shaltout, Hossam A / Washburn, Lisa K / South, Andrew M

    The Journal of pediatrics

    2023  Band 264, Seite(n) 113730

    Abstract: ... No participant had eGFR <90 ml/min/1.73 m: Conclusions: Despite frequent simultaneous exposure ...

    Abstract Objective: To determine whether greater duration of simultaneous exposure to antimicrobials with high nephrotoxicity risk combined with lower-risk antimicrobials (simultaneous exposure) in the neonatal intensive care unit (NICU) is associated with worse later kidney health in adolescents born preterm with very low birth weight (VLBW).
    Study design: Prospective cohort study of participants born preterm with VLBW (<1500 g) as singletons between January 1, 1992, and June 30, 1996. We defined simultaneous exposure as a high-risk antimicrobial, such as vancomycin, administered with a lower-risk antimicrobial on the same date in the NICU. Outcomes were serum creatinine, estimated glomerular filtration rate (eGFR), and first-morning urine albumin-creatinine ratio (ACR) at age 14 years. We fit multivariable linear regression models with days of simultaneous exposure and days of nonsimultaneous exposure as main effects, adjusting for gestational age, birth weight, and birth weight z-score.
    Results: Of the 147 out of 177 participants who had exposure data, 97% received simultaneous antimicrobials for mean duration 7.2 days (SD 5.6). No participant had eGFR <90 ml/min/1.73 m
    Conclusions: Despite frequent simultaneous exposure to high-risk combined with lower-risk nephrotoxic antimicrobials in the NICU, there were no clinically relevant associations with worse kidney health identified in adolescence. Although future studies are needed, these findings may provide reassurance in a population thought to be at increased risk of chronic kidney disease.
    Mesh-Begriff(e) Infant, Newborn ; Humans ; Adolescent ; Birth Weight ; Intensive Care Units, Neonatal ; Prospective Studies ; Kidney ; Glomerular Filtration Rate ; Anti-Infective Agents
    Chemische Substanzen Anti-Infective Agents
    Sprache Englisch
    Erscheinungsdatum 2023-09-16
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 3102-1
    ISSN 1097-6833 ; 0022-3476
    ISSN (online) 1097-6833
    ISSN 0022-3476
    DOI 10.1016/j.jpeds.2023.113730
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