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Low body weight is a risk factor for proteinuria in multiracial Southeast Asian pediatric population
S P Ramirez1, S I Hsu, W McClellan
1Center for Prevention and Research, National Kidney Foundation Singapore. paesr@nus.edu.sg
Insights
Low current body weight, not low birth weight, is strongly linked to proteinuria in children. This suggests environmental factors may worsen the impact of low birth weight on kidney health.
Area of Science:
- Pediatric Nephrology
- Public Health Screening
Background:
- Proteinuria, an indicator of kidney damage, is a concern in pediatric populations.
- Understanding factors contributing to proteinuria is crucial for early intervention and disease prevention.
Purpose of the Study:
- To investigate the association between low birth weight, low current body weight, and proteinuria in children.
- To determine which factor, low birth weight or low current body weight, has a stronger relationship with proteinuria.
Main Methods:
- A cohort of 2,083 children underwent screening, including birth history, anthropometric measurements, blood pressure, and urinalysis.
- Statistical analyses, including multiple logistic regression, were used to assess the relationship between body weight and proteinuria, adjusting for confounders.
Main Results:
- Children with proteinuria had significantly lower mean current body weights compared to those without.
- Lower body weight was associated with an increased risk of proteinuria, independent of blood pressure.
- A trend for lower birth weights was observed in proteinuric children, but the association was not statistically significant.
Conclusions:
- Low current body weight is a stronger predictor of proteinuria in children than low birth weight.
- Environmental factors interacting with low birth weight may exacerbate the risk of renal disease, leading to low current body weight and proteinuria.
Abstract:
We examined the impact of low birth weight and low current body weight on proteinuria in a cohort of children participating in the pilot study of a nationwide screening program. Two thousand eighty-three children underwent screening examinations, including birth history, anthropometric measures, blood pressure measurements, and urinalysis. On this study, children with proteinuria were found to have significantly lower mean body weights compared with children without proteinuria (38.7 +/- 7.6 versus 42.8 +/- 11.0 kg; P < 0.001). Progressively decreasing body weights were associated with increasing degrees of proteinuria (42.8 +/- 11.0, 38.9 +/- 7.6, and 37.2 +/- 8.5 kg for 0, 30, and 100 mg/dL of protein, respectively; P = 0.05). When examined by multiple logistic regression, low body weight was associated with a 1.8-fold greater risk (95% confidence interval, 1.27 to 2.64; P = 0.0019) for proteinuria after adjusting for potential confounders. There were trends for lower birth weights in children with proteinuria (3,047.6 +/- 445.2 versus 3,175.0 +/- 608.6 g for proteinuric and nonproteinuric groups, respectively; P = 0.275) and a greater prevalence of children with birth weights less than the 25th percentile (31.3% versus 25.0%; P = 0.786). The relationship between low current body weight and proteinuria was not explained by differences in blood pressure. In conclusion, low current body weight had a stronger relationship with proteinuria than low birth weight in this pediatric population. We hypothesize that the effect of low birth weight on renal disease may be significantly enhanced by environmental factors that result in a low current body weight.