Normalization of glomerular filtration rate in obese children

Correia-Costa, Liane; Schaefer, Franz; Afonso, Alberto Caldas; Bustorff, Manuela; Guimarães, João Tiago; Guerra, António; Barros, Henrique; Azevedo, Ana

doi:10.1007/s00467-016-3367-8

Cited by 23 publications

(19 citation statements)

References 45 publications

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“…The value of k was 0.55 for children and adolescent girls, while it was 0.7 for adolescent males . We normalized the eGFR to the ideal body weight‐derived body surface area …”

Section: Methodsmentioning

confidence: 99%

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Nonalcoholic fatty liver disease and eGFR levels could be linked by the PNPLA3 I148M polymorphism in children with obesity

et al. 2019

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Summary Background PNPLA3 I148M polymorphism has an effect on modulation of estimated glomerular filtration rate (eGFR) in nonobese nondiabetic adults and in children with histologically confirmed nonalcoholic fatty liver disease (NAFLD). Objectives The objective of the study is to explore the impact of PNPLA3 I148M polymorphism on eGFR in children with obesity with and without NAFLD. Methods We genotyped 591 patients with obesity for PNPLA3 I148M polymorphism. Anthropometrical, biochemical, and instrumental data were collected. NAFLD was defined by the presence of ultrasound‐detected liver steatosis and/or ALT levels greater than 40 IU/L. Results Patients with NAFLD showed significantly lower eGFR levels compared with subjects without NAFLD. Children with PNPLA3 MM genotype showed lower eGFR levels compared with those with either PNPLA3 IM or II genotypes both in the presence and absence of NAFLD. A general linear model for eGFR variance, including gender, duration of obesity, PNPLA3 genotypes, HOMA, BMI‐SDS, LDL‐C, and triglycerides as covariates, confirmed an inverse association between eGFR and PNPLA3 genotype only in the presence of NAFLD. Conclusions Children with obesity and PNPLA3 MM genotype show lower eGFR levels compared with other genotypes, with a major effect of this polymorphism in the presence of NAFLD.

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“…The value of k was 0.55 for children and adolescent girls, while it was 0.7 for adolescent males . We normalized the eGFR to the ideal body weight‐derived body surface area …”

Section: Methodsmentioning

confidence: 99%

“…15 We normalized the eGFR to the ideal body weight-derived body surface area. 16 The presence of steatosis was detected using ultrasound imaging.…”

Section: Serum Creatinine (Mg/dl) Wasmentioning

confidence: 99%

Nonalcoholic fatty liver disease and eGFR levels could be linked by the PNPLA3 I148M polymorphism in children with obesity

et al. 2019

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“…Since all current eGFR equations have been designed for GFR indexed with body surface area (BSA) 8 , eGFR was de-indexed using the BSA. BSA was estimated using the Haycock equation: BSA = 0.02465 × Wt 0.5378 × Ht 0.3964 (with Wt as weight in kilograms and Ht as height in centimetres) 26,27 . De-indexed eGFR was then calculated by multiplying eGFR values by BSA and dividing by 1.73 m 2 .…”

Section: Methodsmentioning

confidence: 99%

The effect of one year lifestyle intervention on eGFR in children and adolescents with overweight, obesity and morbid obesity

Dam

Rijks

Dorenbos

et al. 2019

Sci Rep

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Obesity causes modifications in the kidneys reversed by weight loss in adults. There is little data on renal function and effects of weight loss in children with obesity. The aim of this prospective study was to examine renal function and effect of a lifestyle intervention in children with overweight, obesity and morbid obesity. Two hundred forty-five children (age 12.4 ± 3.3 years, 40% boys, BMI z-score 3.46 ± 0.70) participating in an out-patient lifestyle intervention were included. Children with at least 12 months follow-up (n = 144 (58.8%)) were included in the longitudinal study. Anthropometry, blood analysis and blood pressure measurements were performed at baseline and follow-up. Glomerular filtration rate (GFR) was estimated using the Schwartz and FAS equation. eGFR was de-indexed using body surface area. Different cut-off points for defining glomerular hyperfiltration were used for stratification. Depending on the definition and equation used, glomerular hyperfiltration was present in 2% to 18% of the participants. After intervention, de-indexed eGFR decreased significantly in children with baseline glomerular hyperfiltration, depending on the eGFR equation and definition for glomerular hyperfiltration used. No associations of changes in eGFR with changes in BMI z-score, blood pressure or parameters of glucose and lipid metabolism were found. In conclusion, after one year of lifestyle intervention, eGFR decreases in hyperfiltrating children and adolescents with overweight, obesity and morbid obesity. eGFR and changes over time in children with obesity depend on eGFR equation used and on de-indexing for body surface area.

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“…In clinical practice to receive generally used value (standard in 1.73 m 2 body surface), the absolute GFR value was multiplied by 1.73 and divided by the patients BSA, measured by the Haycock formula (17). To approve alternative GFR adapters by the ratio method, abso-lute GFR rates were divided by the value of body size descriptor, and received different GFR rates adapted to several body size descriptors (13). Hyperfiltration was determined as a GFR > 134.3 mL/min, in accordance with published reference ranges (27).…”

Section: Methodsmentioning

confidence: 99%

The Glomerular Filtration Rate and Proteinuria in Obese Children

Renda

2018

Iran J Pediatr

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Background: Obesity increases the risk of many pathologies, including cardiovascular and renal diseases. This study aimed to determine the association between obesity and proteinuria as well as glomerular hemodynamic changes (an early marker of kidney damage) in obese children and its relationship with metabolic syndrome. Methods: This case-control study included 112 overweight and obese male and female patients aged 7 -16 years, and 35 age-and gender-matched healthy controls. The obese patients were divided into 4 subgroups according to BMI:normal weight (control group), overweight, obese, morbidly obese. The glomerular filtration rate was estimated using classical and adjusted formulas based on the various body size descriptors of Leger, Schwartz, Filler, and Zappitelli, and chronic kidney disease formulas in all patients and controls. Creatinine, cystatin C, 24-hour urine protein, and the estimated glomerular filtration were compared between groups. Results: Blood pressure, creatinine, and 24-hour urine protein values were significantly higher in the overweight and obese patient subgroups (P < 0.05). The estimated glomerular filtration rate, which was calculated using creatinine or cystatin C, was higher in the obese patients and subgroups than in the control group (P < 0.05). In contrast, the estimated glomerular filtration rate measured using both classical and adjusted formulas was significantly lower in the obese patients than in the controls (P < 0.05). Conclusions: Early indicators of renal damage are elevated urine protein and renal function test results compatible with impaired renal function. As such, obese pediatric patients should be routinely monitored for blood pressure, renal function, and proteinuria.

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Normalization of glomerular filtration rate in obese children

Abstract: Indexing of GFR to BSA calculated from the ideal-rather than actual-body weight is a promising approach to avoid overcorrection when studying obese children. Further studies should assess the accuracy of this approach across the full range of age and BMI distribution.

Cited by 23 publications

References 45 publications

Nonalcoholic fatty liver disease and eGFR levels could be linked by the PNPLA3 I148M polymorphism in children with obesity

Nonalcoholic fatty liver disease and eGFR levels could be linked by the PNPLA3 I148M polymorphism in children with obesity

The effect of one year lifestyle intervention on eGFR in children and adolescents with overweight, obesity and morbid obesity

The Glomerular Filtration Rate and Proteinuria in Obese Children

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