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Interpretation of body mass index in children with CKD

Tao Gao1, Mary B Leonard, Babette Zemel

  • 1Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.

Clinical Journal of the American Society of Nephrology : CJASN
|February 4, 2012
PubMed

Insights

Body mass index (BMI) adjusted for height-age better reflects lean mass and adiposity in children with chronic kidney disease (CKD). This validated approach improves body composition assessment in pediatric CKD patients.

Area of Science:

  • Pediatric Nephrology
  • Body Composition Analysis
  • Growth and Development

Background:

  • Clinical guidelines suggest using BMI-height-age-z for children with CKD to account for growth differences.
  • This recommendation lacks validation in pediatric CKD populations.
  • Accurate body composition assessment is crucial for managing children with CKD.

Purpose of the Study:

  • To compare body composition (lean mass and adiposity) in children with CKD versus healthy children.
  • To validate the use of BMI-height-age-z in reflecting body composition in pediatric CKD.
  • To determine if BMI-height-age-z offers a more accurate assessment than BMI-age-z in CKD.

Main Methods:

  • Cross-sectional study involving 143 children with CKD and 958 healthy children (ages 5-21).
  • Dual-energy x-ray absorptiometry (DXA) used to measure fat mass (FM) and lean mass (LM).
  • BMI-age-z and BMI-height-age-z calculated using CDC reference data.

Main Results:

  • Children with CKD showed significantly different lean mass and adiposity Z-scores compared to healthy controls.
  • Males with CKD had higher lean mass Z-scores across all stages.
  • Females with severe CKD had significantly higher fat mass Z-scores.
  • Expressing BMI relative to height-age improved the underestimation of relative lean mass and adiposity.

Conclusions:

  • BMI-height-age-z accurately reflects relative lean mass and adiposity in children with CKD.
  • This finding supports the use of BMI-height-age-z in clinical practice for pediatric CKD.
  • The study validates a key recommendation for assessing body composition in this population.
Abstract

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