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Prenatal risk factors for childhood CKD
Christine W Hsu1, Kalani T Yamamoto2, Rohan K Henry3
1Kidney Research Institute and Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington; Division of Nephrology, Seattle Children's Hospital, Department of Pediatrics, University of Washington, Seattle, Washington; cwhsu8@uw.edu.
Journal of the American Society of Nephrology : JASN
|April 19, 2014
Summary
Prenatal factors like low birth weight and maternal gestational diabetes may increase childhood chronic kidney disease (CKD) risk. Further research could explore modifying these risks to prevent pediatric CKD.
Area of Science:
- Pediatric Nephrology
- Public Health
- Obstetrics
Background:
- Chronic kidney disease (CKD) in children can have long-term health implications.
- Prenatal programming is a potential pathway influencing the development of childhood diseases.
- Identifying prenatal risk factors is crucial for early intervention strategies.
Purpose of the Study:
- To investigate the association between specific prenatal risk factors and the development of childhood CKD.
- To analyze the impact of birth weight, maternal diabetes mellitus (DM), and maternal overweight/obesity on CKD risk.
- To explore associations with specific CKD subtypes, such as renal dysplasia/aplasia and obstructive uropathy.
Main Methods:
- Population-based case-control study including 1994 patients with childhood CKD and 20,032 controls.
- Linked maternal and infant characteristics from birth records (1987-2008) with hospital discharge data.
- Logistic regression analysis was used to assess the association of prenatal factors with childhood CKD.
Main Results:
- Low birth weight (adjusted OR 2.88) and maternal gestational DM (adjusted OR 1.54) were significantly associated with increased childhood CKD risk.
- Maternal overweight (adjusted OR 1.24) and obesity (adjusted OR 1.26) also showed significant associations.
- Low birth weight and maternal pregestational DM were linked to renal dysplasia/aplasia, while low birth weight, maternal gestational DM, and overweight/obesity were linked to obstructive uropathy.
Conclusions:
- Prenatal factors, including birth weight and maternal metabolic conditions, appear to play a role in the risk of developing childhood CKD.
- Specific prenatal factors are associated with distinct CKD subtypes, suggesting different developmental pathways.
- Further research is warranted to determine if modifying these prenatal factors can reduce the incidence of pediatric CKD.
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