Low birth weight and prematurity are risk factors for hypertension in adulthood. Few studies in preterm or full-term born children reported on plasma renin activity (PRA). We tested the hypothesis that renin might modulate the incidence of hypertension associated with prematurity. We enrolled 93 prematurely born children with birth weight 1000 g and 87 healthy controls born at term, who were all examined at ≈11 years. Renal length and glomerular filtration rate derived from serum cystatin C were 0.28 cm (95% confidence interval, 0.09–0.47) and 11.5 mL/min per 1.73 m2 (6.4–16.6) lower in cases, whereas their systolic/diastolic blood pressure (BP) was 7.5 mm?Hg (4.8–10.3)/4.0 mm?Hg (2.1–5.8) higher (P0.001 for all). The odds of having systolic prehypertension or systolic hypertension associated with extreme low birth weight were 6.43 (2.52–16.4; P0.001) and 10.9 (2.46–48.4; P=0.002). Twenty-four hours of urinary sodium excretion was similar in cases and controls (102.1 versus 106.8 mmol; P=0.47). Sodium load per nephron was estimated as sodium excretion divided by kidney length (mmol/cm). PRA was 0.54 ng/mL per hour (0.23–0.85; P=0.001) lower in cases. PRA, systolic BP, and sodium load were available in 43 cases and 56 controls. PRA decreased with systolic BP (slope ?0.022 ng/mL per hour/?mm?Hg; P=0.048), but was unrelated to sodium load (slope +0.13 mmol/cm?mm?Hg; P=0.54). The slope of PRA on systolic BP was similar (P=0.17) in cases and controls. In conclusion, extremely low birth weight predisposes young adolescents to low-renin hypertension, but does not affect the inverse association between PRA and BP.
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机译：低出生体重和早产是成年高血压的危险因素。在早产或足月儿中很少有研究报道血浆肾素活性（PRA）。我们检验了肾素可能调节与早产有关的高血压发生率的假设。我们招募了93例出生体重<1000 g的早产儿和87例足月出生的健康对照者，他们均在≈11岁时接受了检查。血清半胱氨酸蛋白酶抑制剂C引起的肾脏长度和肾小球滤过率分别降低0.28 cm（95％置信区间，0.09–0.47）和每1.73 m2（6.4-16.6）降低11.5 mL / min，而其收缩压/舒张压（BP） ）升高7.5毫米汞柱（4.8-10.3）/4.0毫米汞柱（2.1-5.8）（所有P <0.001）。出生体重极低导致收缩期高血压或收缩期高血压的几率分别为6.43（2.52-16.4; P <0.001）和10.9（2.46-48.4; P = 0.002）。在病例和对照中，二十四小时尿钠排泄相似（102.1对106.8 mmol; P = 0.47）。每个肾单位的钠负荷估计为钠排泄除以肾脏长度（mmol / cm）。在某些情况下，PRA每小时降低0.54 ng / mL（0.23-0.85; P = 0.001）。 PRA，收缩压和钠负荷在43例和56例对照中可用。 PRA随收缩压而下降（斜率≥0.022ng / mL /小时/?mm?Hg;P=0.048），但与钠负荷无关（斜率+0.13 mmol / cm？mm？Hg; P = 0.54）。在病例和对照中，PRA在收缩压上的斜率相似（P = 0.17）。总之，极低的出生体重使年轻青少年易患低肾素高血压，但并不影响PRA与BP之间的逆相关性。
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