Daishi Hirano1,2, Kenji Ishikura3, Osamu Uemura4, Shuichi Ito3,5, Naohiro Wada6, Motoshi Hattori7, Yasuo Ohashi8, Yuko Hamasaki9, Ryojiro Tanaka10, Koichi Nakanishi11, Tetsuji Kaneko12, Masataka Honda13. 1. Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan. 2. Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan. 3. Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan. 4. Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Aichi, Japan. 5. Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan. 6. Department of Pediatric Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan. 7. Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan. 8. Department of Integrated Science and Technology for Sustainable Society (Faculty of Science and Technology), Chuo University, Tokyo, Japan. 9. Department of Pediatric Nephrology, Toho University Faculty of Medicine, Tokyo, Japan. 10. Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan. 11. Department of Pediatrics, Wakayama Medical University, Wakayama, Japan. 12. Department of Clinical Research, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 13. Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Abstract
BACKGROUND: Although numerous epidemiological surveys performed across several continents and ethnic groups have linked low birth weight (LBW) to increased risk of chronic kidney disease (CKD) in adulthood, the effects of birth weight and prematurity on development of CKD in childhood have not been clearly established. METHODS: Data on sex, LBW incidence and gestational age were compared between paediatric CKD cases and a control group. Paediatric CKD cases were obtained from a nationwide survey conducted by the Pediatric CKD Study Group in Japan. The population attributable fraction was calculated to evaluate the effects of reducing the prevalence of LBW infants (LBWI). RESULTS: Of 447 individuals born between 1993 and 2010 that fulfilled the eligibility criteria, birth weight data were obtained for 381 (85.2%) (231 boys and 150 girls), 106 (27.8%) of whom were LBWI. The proportion of LBWI in the general population during the same period was much lower (8.6%). Therefore, the risk ratio (RR) for paediatric CKD was significantly higher in the LBW group [crude RR: 4.10; 95% confidence interval (CI) 3.62-5.01], and the overall impact on paediatric CKD for removal of LBW amounted to 21.1% (95% CI 16.0-26.1%). In addition, 82 patients (21.9%) with paediatric CKD were born prematurely (before 37 weeks of gestation), and as with LBW, a strong correlation was observed between prematurity and CKD (RR: 4.73; 95% CI 3.91-5.73). CONCLUSIONS: Both birth weight and gestational age were strongly associated with childhood-onset CKD in this study.
BACKGROUND: Although numerous epidemiological surveys performed across several continents and ethnic groups have linked low birth weight (LBW) to increased risk of chronic kidney disease (CKD) in adulthood, the effects of birth weight and prematurity on development of CKD in childhood have not been clearly established. METHODS: Data on sex, LBW incidence and gestational age were compared between paediatric CKD cases and a control group. Paediatric CKD cases were obtained from a nationwide survey conducted by the Pediatric CKD Study Group in Japan. The population attributable fraction was calculated to evaluate the effects of reducing the prevalence of LBW infants (LBWI). RESULTS: Of 447 individuals born between 1993 and 2010 that fulfilled the eligibility criteria, birth weight data were obtained for 381 (85.2%) (231 boys and 150 girls), 106 (27.8%) of whom were LBWI. The proportion of LBWI in the general population during the same period was much lower (8.6%). Therefore, the risk ratio (RR) for paediatric CKD was significantly higher in the LBW group [crude RR: 4.10; 95% confidence interval (CI) 3.62-5.01], and the overall impact on paediatric CKD for removal of LBW amounted to 21.1% (95% CI 16.0-26.1%). In addition, 82 patients (21.9%) with paediatric CKD were born prematurely (before 37 weeks of gestation), and as with LBW, a strong correlation was observed between prematurity and CKD (RR: 4.73; 95% CI 3.91-5.73). CONCLUSIONS: Both birth weight and gestational age were strongly associated with childhood-onset CKD in this study.
Authors: Keia R Sanderson; Emily Chang; Erica Bjornstad; Susan L Hogan; Yichun Hu; David Askenazi; Rebecca C Fry; T Michael O'Shea Journal: Front Pediatr Date: 2020-05-12 Impact factor: 3.418