The role of hepatic and renal functions in the development of retinopathy of prematurity: Is proteinuria a new risk factor?

Abstract

Purpose: To investigate the association of hepatic and renal parameters with the development of retinopathy of prematurity (ROP) in premature infants with a gestational age ≤ 32 weeks.Methods: Medical records of 240 preterm infants were reviewed retrospectively, 85 of them were grouped as type 1, type 2 ROP and control group. These groups test results of rst-month hepatic and renal function were compared for the risk of development of ROP and the development of type 1 ROP.Results: In this study, 12, 35 and 38 infants were enrolled in the type 1, type 2 ROP and control group, respectively. The average gestational age and birth weight were higher; however, the duration of oxygen treatment was lower in the control group (p<0.001). The blood glucose level was signi cantly higher in the type 1 ROP group than in the other groups (p=0.023). The mean of total serum bilirubin of the type 1 ROP group was signi cantly lower than those of the type 2 ROP and control group (p=0.032). Proteinuria was present in 85.7% of preterms with treatment-requiring ROP and proteinuria increased the risk of ROP by 3.9 times (OR with 95% CI: 3.9 (1.19-12.75), p=0.042).Conclusion: We found signi cantly higher blood glucose and lower total bilirubin level in the type 1 ROP group. Moreover, our ndings suggest that proteinuria seems to be a new and important risk factor for both ROP and type 1 ROP in preterm infants.

Latest Trends in Retinopathy of Prematurity: Research on Risk Factors, Diagnostic Methods and Therapies

“…Moreover, premature babies with proteinuria and GA ≤ 32 weeks, have a fourfold risk of developing a severe form of ROP. 26 Both the kidney and the retina share a similar embryological development. 27 The stratigraphy of the glomerular basement membrane is similar to that of the outer retinal barrier, and both podocytes and EPR cells actively mediate the molecular exchange, playing the role of a metabolic barrier.…”

“…Therefore, a low level of total bilirubin seems to influence ROP but, taking into account the dual behavior, knowing the lower limit at which it plays an antioxidant role, it is as important as the limit above which induces toxic effects. 26 Ji Woong and colleagues drew attention to the necessity of differentiating the risk factors involved in the development of ROP from those incriminated in the progression of ROP. Respiratory distress syndrome along with bronchopulmonary dysplasia are incriminated in the etiopathogenesis of ROP as a result of supplemental oxygen administration, but the way in which these risk factors intervene is different.…”