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Published on: August 5, 2010
Predictors of becoming overweight among pediatric patients at risk for urinary tract infections
T W Gaither1, C S Cooper2, Z Kornberg1
1Department of Urology, University of California, San Francisco, USA.
Insights
Significant weight gain is common in children at risk for urinary tract infections (UTIs). Hispanic/Latino ethnicity, persistent reflux, and infant age are key risk factors for becoming overweight.
Area of Science:
- Pediatric Nephrology
- Pediatric Urology
- Obesity Research
Background:
- Childhood obesity is linked to urinary dysfunction, but temporal relationships are unclear due to retrospective studies.
- Identifying risk factors for weight gain in children prone to recurrent urinary tract infections (UTIs) is crucial for early intervention.
Purpose of the Study:
- To investigate risk factors associated with significant weight gain in children susceptible to recurrent UTIs.
- To analyze the impact of ethnicity, age, reflux, prophylactic antibiotics, and bladder and bowel dysfunction (BBD) on body mass index (BMI) percentile changes.
Main Methods:
- Secondary analysis of the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) and Careful Urinary Tract Infection Evaluation (CUTIE) trials.
- Multivariable logistic regression was used to identify independent risk factors for a significant increase in BMI percentile (>85th).
Main Results:
- Of 446 children, 17% became overweight. Hispanic/Latino ethnicity (aOR=3.3), infant age at enrollment (aOR=2.1), and persistent reflux (aOR=2.1) were independently associated with increased BMI percentile.
- Prophylactic antibiotics and BBD were not significantly associated with weight gain.
Conclusions:
- Significant BMI percentile gain is prevalent in children at risk for UTIs.
- Hispanic/Latino ethnicity, persistent reflux, and younger age (infants) are identified as independent risk factors for overweight development.
- Clinical discussions regarding overweight risk are essential for managing children at risk for UTIs, particularly those in identified subpopulations.
Background:
The association between obesity and urinary dysfunction in childhood has been described, albeit through retrospective analysis, making temporal relationships difficult to establish.
Objective:
The objective of this study was to determine risk factors for significant weight gain in children at risk for recurrent urinary tract infections.
Study Design:
A secondary analysis of the Randomized Intervention for Children with Vesicoureteral Reflux and Careful Urinary Tract Infection Evaluation trials was conducted. The outcome of interest in these children was significant increase in body mass index (BMI) percentile (>85th BMI percentile for sex and age) in previously normal-weight children. Multivariable logistic regression was used to determine the independent effects of predetermined risk factors.
Results:
In total, 446 patients were included in the study. Most patients aged less than 1 year at study entry (229, 51%), and 399 (89%) of patients were female. Eighty-four patients (17%) became clinically overweight. Patients assigned to prophylactic antibiotics were not more likely to gain significant BMI percentiles (adjusted odds ratio [aOR] = 1.1, 95% confidence interval [CI]=0.6-1.8). Significant BMI percentiles were gained in Hispanic/Latino patients compared with whites (aOR = 3.3, 95% CI=1.7-6.4), in children who were infants at study enrollment compared with non-infants (aOR = 2.1, 95% CI=1.2-3.8), and in those with persistent reflux during the study period (aOR = 2.1, 95% CI=1.0-4.3). Neither patients assigned to prophylactic antibiotics (aOR = 1.1, 95% CI=0.6-1.8) nor patients with bladder and bowel dysfunction (BBD) (aOR = 1.2, 95% CI=0.6-2.3) were more likely to gain significant BMI percentiles.
Discussion:
Significant BMI percentile gain is common in patients at risk for UTIs. Hispanic/Latino ethnicity, persistent reflux, and younger age, specifically infants than non-infants, were identified as independent risk factors for becoming overweight in this population. Exposure to prophylactic antibiotics and BBD were not associated with becoming overweight.
Conclusion:
Risk for becoming overweight should be discussed when managing patients at risk for UTIs, especially in the subpopulations identified.
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