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The association between abnormal birth history and growth in children with CKD

Larry A Greenbaum1, Alvaro Muñoz, Michael F Schneider

  • 1Division of Pediatric Nephrology, Emory University, 2015 Uppergate Drive, NE, Atlanta, GA 30322, USA. lgreen6@emory.edu

Clinical Journal of the American Society of Nephrology : CJASN
|October 30, 2010
PubMed

Insights

Low birth weight and being small for gestational age are new risk factors for poor growth in children with chronic kidney disease (CKD). These birth history factors impact height and weight, regardless of kidney function.

Area of Science:

  • Pediatric Nephrology
  • Growth and Development
  • Chronic Kidney Disease

Background:

  • Poor linear growth is a known complication in children with chronic kidney disease (CKD).
  • Abnormal birth history, including low birth weight (LBW), prematurity, small for gestational age (SGA), and intensive care unit (ICU) admission at birth, may influence growth outcomes.
  • The prevalence of these birth complications in children with CKD requires further investigation.

Purpose of the Study:

  • To evaluate if abnormal birth history factors (LBW, prematurity, SGA, ICU at birth) are associated with poor growth outcomes in children with CKD.
  • To identify specific birth history characteristics that predict impaired linear growth and weight gain in pediatric CKD patients.
  • To understand the independent contribution of birth history to growth deficits in children with varying degrees of CKD.

Main Methods:

  • Analysis of growth outcomes (height and weight z-scores) from 1393 visits of 426 children in the Chronic Kidney Disease in Children Study.
  • Inclusion of participants with a median baseline glomerular filtration rate (GFR) of 42.9 ml/min/1.73 m(2), with 21% having a glomerular diagnosis.
  • Multivariate analyses were performed to assess the impact of birth history on growth, adjusting for relevant covariates.

Main Results:

  • A significant prevalence of LBW (17%), SGA (14%), prematurity (12%), and ICU admission (40%) was observed in the study cohort.
  • Multivariate analyses revealed that LBW and SGA were significantly associated with poorer current height and weight z-scores.
  • The negative impact of SGA on weight was more pronounced in children with glomerular kidney disease compared to those with nonglomerular diagnoses.

Conclusions:

  • Low birth weight (LBW) and being small for gestational age (SGA) are identified as novel risk factors for short stature and lower weight percentiles in children with mild to moderate CKD.
  • These birth history factors independently contribute to growth deficits, irrespective of the level of kidney function.
  • The findings highlight the importance of considering birth history in the management and monitoring of growth in pediatric CKD populations.
Abstract

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