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Updated: Jun 22, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
The evaluation of kidney function estimation during lifestyle intervention in children with overweight and obesity
Mark J C M van Dam1, Hans Pottel2, Pierre Delanaye3,4
1Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Pediatrics, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center +, MosaKids Children's Hospital, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. mark.van.dam@mumc.nl.
Insights
Lifestyle intervention for childhood obesity shows a slight increase in rescaled serum creatinine (SCr/Q), indicating a minor decrease in estimated kidney function. This change appears independent of BMI z-score reduction.
Area of Science:
- Pediatric Nephrology
- Obesity Medicine
- Clinical Trials
Background:
- Children with overweight and obesity face increased risk of chronic kidney disease (CKD).
- Lifestyle intervention is the primary treatment for childhood obesity, involving body proportion changes.
- This study investigates the impact of lifestyle intervention on kidney function estimation in obese children.
Purpose of the Study:
- To evaluate the effect of a lifestyle intervention on creatinine-based kidney function estimates in children with overweight and obesity.
- To determine if changes in body composition during intervention correlate with kidney function markers.
Main Methods:
- A longitudinal lifestyle intervention study included 614 children (mean age 12.17 years) with overweight/obesity.
- Serum creatinine (SCr) was rescaled using Q-age and Q-height polynomials for kidney function estimation.
- Data were analyzed using linear mixed regression, accounting for significant loss to follow-up.
Main Results:
- At baseline, most children had normal SCr/Q values (0.67-1.33).
- SCr/Q significantly increased yearly during the intervention, suggesting a slight decline in estimated kidney function (eGFR FAS reduction of 1.1-4.1 mL/min/1.73 m² per visit).
- BMI z-score decreased, particularly in males, but showed no correlation with the change in rescaled SCr.
Conclusions:
- Multidisciplinary lifestyle intervention in obese children leads to a slight increase in rescaled serum creatinine (SCr/Q).
- This observed change in kidney function estimation is independent of BMI z-score reduction.
- Long-term clinical significance of this minor estimated kidney function decrease requires further investigation in extended follow-up studies.
Background:
Children with overweight and obesity are at risk for developing chronic kidney disease (CKD). During lifestyle adjustment, the first step in the treatment of childhood obesity, body proportions are likely to change. The aim of this study was to examine how lifestyle intervention affects creatinine-based kidney function estimation in children with overweight and obesity.
Methods:
This longitudinal lifestyle intervention study included 614 children with overweight and obesity (mean age 12.17 ± 3.28 years, 53.6% female, mean BMI z-score 3.32 ± 0.75). Loss to follow-up was present: 305, 146, 70, 26, and 10 children were included after 1, 2, 3, 4, and 5 (about yearly) follow-up visits, respectively. Serum creatinine (SCr) was rescaled using Q-age and Q-height polynomials.
Results:
At baseline, 95-97% of the children had a SCr/Q-height and SCr/Q-age in the normal reference range [0.67-1.33]. SCr/Q significantly increased each (about yearly) follow-up visit, and linear mixed regression analyses demonstrated slopes between 0.01 and 0.04 (corresponding with eGFR FAS reduction of 1.1-4.1 mL/min/1.73 m2) per visit. BMI z-score reduced in both sexes and this reduction was significantly higher in males. No correlation between change in rescaled SCr and BMI z-score reduction could be demonstrated.
Conclusions:
Rescaled serum creatinine (SCr/Q) slightly increases during multidiscipline lifestyle intervention in this cohort of children with overweight and obesity. This effect seems to be independent from change in BMI z-score. Whether this minor decrease in estimated kidney function has clinical consequences in the long term remains to be seen in trials with a longer follow-up period.
Clinical Trial Registration:
ClinicalTrial.gov; Registration Number: NCT02091544.
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