The Association between Abnormal Birth History and Growth in Children with CKD

Greenbaum, Laurence; Muñoz, Álvaro; Schneider, Michael; Kaskel, Frederick J.; Askenazi, David; Jenkins, Randall; Hotchkiss, Hilary; Moxey-Mims, Marva; Furth, Susan L.; Warady, Bradley A.

doi:10.2215/cjn.08481109

Cited by 81 publications

(47 citation statements)

References 26 publications

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“…22 An observational cohort study among 426 children with congenital kidney disease showed that low birth weight and being small for gestational age are risk factors for poor growth outcomes in children with mild and moderate CKD. 23 We observed that younger gestational age and lower gestational age-adjusted birth weight are associated with both a lower kidney volume and a lower eGFR in school-aged children. These findings are in line with previous studies showing that low birth weight for gestational age is associated with kidney function in childhood.…”

Section: Fetal and Early Childhood Growth And Childhood Kidneymentioning

confidence: 60%

Fetal and Infant Growth Patterns and Kidney Function at School Age

Bakker

Gaillard

Franco³

et al. 2014

Journal of the American Society of Nephrology

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Low birth weight is associated with ESRD. To identify specific growth patterns in early life that may be related to kidney function in later life, we examined the associations of longitudinally measured fetal and infant growth with kidney function in school-aged children. This study was embedded in a populationbased prospective cohort study among 6482 children followed from fetal life onward. Fetal and childhood growth was measured during second and third trimesters of pregnancy, at birth, and at 6, 12, 24, 36, and 48 months postnatally. At the age of 6 years, we measured kidney volume by ultrasound. GFR was estimated using blood creatinine levels. Higher gestational age-adjusted birth weight was associated with higher combined kidney volume and higher eGFR (per 1 SD score increase in birth weight; 1.27 cm 3 [95% confidence interval, 0.61 to 1.93] and 0.78 ml/min per 1.73 m 2 [95% CI, 0.16 to 1.39], respectively). Fetal weight, birth weight, and weight at 6 months were positively associated with childhood kidney volume, whereas higher second trimester fetal weight was positively associated with higher GFR (all P values,0.05). Fetal and childhood lengths were not consistently associated with kidney function. In this cohort, lower fetal and early infant weight growth is associated with smaller kidney volume in childhood, whereas only lower fetal weight growth is associated with lower kidney function in childhood, independent of childhood growth. Whether these associations lead to an increased risk of kidney disease needs to be studied further.

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Section: Fetal and Early Childhood Growth And Childhood Kidneymentioning

confidence: 60%

Fetal and Infant Growth Patterns and Kidney Function at School Age

Bakker

Gaillard

Franco³

et al. 2014

Journal of the American Society of Nephrology

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“…Whether a more vigorous treatment will translate into better growth outcome in KTx patients needs to be proven in future trials. Intrauterine growth restriction and parental height are significant predictors of total body height in the general population and in children with CKD (27)(28)(29)(30)(31). Malnutrition is an important factor contributing to growth failure in children with CKD, especially during young age.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Growth after Kidney Transplantation among Children with ESRD

Franke

Thomas

Steffens

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Poor linear growth is a frequent complication of CKD. This study evaluated the effect of kidney transplantation on age-related growth of linear body segments in pediatric renal transplant recipients who were enrolled from May 1998 until August 2013 in the CKD Growth and Development observational cohort study.Design, setting, participants, & measurements Linear growth (height, sitting height, arm and leg lengths) was prospectively investigated during 1639 annual visits in a cohort of 389 pediatric renal transplant recipients ages 2-18 years with a median follow-up of 3.4 years (interquartile range, 1.9-5.9 years). Linear mixed-effects models were used to assess age-related changes and predictors of linear body segments.Results During early childhood, patients showed lower mean SD scores (SDS) for height (21.7) and a markedly elevated sitting height index (ratio of sitting height to total body height) compared with healthy children (1.6 SDS), indicating disproportionate stunting (each P,0.001). After early childhood a sustained increase in standardized leg length and a constant decrease in standardized sitting height were noted (each P,0.001), resulting in significant catch-up growth and almost complete normalization of sitting height index by adult age (0.4 SDS; P,0.01 versus age 2-4 years). Time after transplantation, congenital renal disease, bone maturation, steroid exposure, degree of metabolic acidosis and anemia, intrauterine growth restriction, and parental height were significant predictors of linear body dimensions and body proportions (each P,0.05). ConclusionsChildren with ESRD present with disproportionate stunting. In pediatric renal transplant recipients, a sustained increase in standardized leg length and total body height is observed from preschool until adult age, resulting in restoration of body proportions in most patients. Reduction of steroid exposure and optimal metabolic control before and after transplantation are promising measures to further improve growth outcome.

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“…77 Assessments of the NICU graduate should continue into adolescence, a time when many children see their pediatrician less frequently. Rapid growth in puberty often unmasks renal dysfunction 78 because abnormal kidneys may be unable to accommodate the demands of increased growth.…”

Section: Figurementioning

confidence: 99%

Short-Term Gestation, Long-Term Risk: Prematurity and Chronic Kidney Disease

2013

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Thanks to remarkable advances in neonatal intensive care, infants who once had little chance for survival can now enter adulthood. Yet the consequences of premature birth or low birth weight (LBW) on nephrogenesis, final nephron number, and long-term kidney function are unclear. This review focuses on the theory, experimental evidence, and observational data that suggest an increased risk of chronic kidney disease (CKD) for infants born prematurely. Many premature and LBW infants begin life with an incomplete complement of immature nephrons. They are then exposed to a variety of external stressors that can hinder ongoing kidney development or cause additional nephron loss such as hemodynamic alterations, nephrotoxic medications, infections, and suboptimal nutrition. Acute kidney injury, in particular, may be a significant risk factor for the development of CKD. According to Brenner' s hypothesis, patients with decreased nephron number develop hyperfiltration that results in sodium retention, hypertension, nephron loss, and CKD due to secondary focal segmental glomerulosclerosis. Because the risk of CKD in premature and LBW infants has not been accurately determined, there are no evidence-based recommendations for screening or management. Yet with the first generation of infants from the surfactant era only now reaching adulthood, it is possible that there is already an unrecognized epidemic of CKD. We suggest individualized, risk-based assessments of premature and LBW infants due to the increased risk of CKD and call for additional research into the long-term risk for CKD these infants face.

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The Association between Abnormal Birth History and Growth in Children with CKD

Cited by 81 publications

References 26 publications

Fetal and Infant Growth Patterns and Kidney Function at School Age

Fetal and Infant Growth Patterns and Kidney Function at School Age

Patterns of Growth after Kidney Transplantation among Children with ESRD

Short-Term Gestation, Long-Term Risk: Prematurity and Chronic Kidney Disease

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