Nancy M Rodig1, Jennifer Roem2, Michael F Schneider2, Patricia W Seo-Mayer3, Kimberly J Reidy4, Frederick J Kaskel4, Amy J Kogon5, Susan L Furth5, Bradley A Warady6. 1. Department of Pediatrics, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA. nancy.rodig@childrens.harvard.edu. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 3. Department of Pediatrics, Inova Children's Hospital and Pediatric Specialists of Virginia, Falls Church, VA, USA. 4. Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA. 5. Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. 6. Department of Pediatrics, Children's Mercy Kansas City, Kansas City, MO, USA.
Abstract
BACKGROUND: Longitudinal changes in body mass index (BMI) among overweight and obese children with chronic kidney disease (CKD) are not well characterized. We studied longitudinal trajectories and correlates of these trajectories, as results may identify opportunities to optimize health outcomes. METHODS: Longitudinal changes in age-sex-specific BMI z-scores over 1851 person-years of follow-up were assessed in 524 participants of the Chronic Kidney Disease in Children Study. A total of 353 participants were categorized as normal (BMI > 5th to < 85th percentile), 56 overweight (BMI ≥ 85th to 95th percentile) and 115 obese (BMI ≥ 95th percentile) based on the average of three BMI measurements during the first year of follow-up. Studied covariates included age, sex, race, CKD etiology, corticosteroid usage, household income, and maternal education. RESULTS: In unadjusted analysis, BMI z-scores decreased over time in elevated BMI groups (overweight: mean = - 0.06 standard deviations (SD) per year, 95% CI: - 0.11, - 0.01; obese: mean = - 0.04 SD per year, 95% CI: - 0.07, - 0.01). Among obese children, only age was associated with change in BMI z-score; children < 6 years had a mean decrease of 0.19 SD during follow-up (95% CI: - 0.30, - 0.09). Socioeconomic factors were not associated with change in BMI. CONCLUSION: Overweight and obese children with CKD demonstrated a significant annual decline in BMI, though the absolute change was modest. Among obese children, only age < 6 years was associated with significant decline in BMI. Persistence of elevated BMI in older children and adolescents with CKD underscores the need for early prevention and effective intervention.
BACKGROUND: Longitudinal changes in body mass index (BMI) among overweight and obese children with chronic kidney disease (CKD) are not well characterized. We studied longitudinal trajectories and correlates of these trajectories, as results may identify opportunities to optimize health outcomes. METHODS: Longitudinal changes in age-sex-specific BMI z-scores over 1851 person-years of follow-up were assessed in 524 participants of the Chronic Kidney Disease in Children Study. A total of 353 participants were categorized as normal (BMI > 5th to < 85th percentile), 56 overweight (BMI ≥ 85th to 95th percentile) and 115 obese (BMI ≥ 95th percentile) based on the average of three BMI measurements during the first year of follow-up. Studied covariates included age, sex, race, CKD etiology, corticosteroid usage, household income, and maternal education. RESULTS: In unadjusted analysis, BMI z-scores decreased over time in elevated BMI groups (overweight: mean = - 0.06 standard deviations (SD) per year, 95% CI: - 0.11, - 0.01; obese: mean = - 0.04 SD per year, 95% CI: - 0.07, - 0.01). Among obese children, only age was associated with change in BMI z-score; children < 6 years had a mean decrease of 0.19 SD during follow-up (95% CI: - 0.30, - 0.09). Socioeconomic factors were not associated with change in BMI. CONCLUSION: Overweight and obese children with CKD demonstrated a significant annual decline in BMI, though the absolute change was modest. Among obese children, only age < 6 years was associated with significant decline in BMI. Persistence of elevated BMI in older children and adolescents with CKD underscores the need for early prevention and effective intervention.
Entities:
Keywords:
Children; Chronic kidney disease; Elevated body mass index; Longitudinal; Obesity; Overweight
Authors: Frank W Ayestaran; Michael F Schneider; Frederick J Kaskel; Poyyapakkam R Srivaths; Patricia W Seo-Mayer; Marva Moxey-Mims; Susan L Furth; Bradley A Warady; Larry A Greenbaum Journal: Pediatr Nephrol Date: 2016-02-08 Impact factor: 3.714
Authors: Chi-yuan Hsu; Charles E McCulloch; Carlos Iribarren; Jeanne Darbinian; Alan S Go Journal: Ann Intern Med Date: 2006-01-03 Impact factor: 25.391
Authors: Patrick H Casey; Pippa M Simpson; Jeffrey M Gossett; Margaret L Bogle; Catherine M Champagne; Carol Connell; David Harsha; Beverly McCabe-Sellers; James M Robbins; Janice E Stuff; Judith Weber Journal: Pediatrics Date: 2006-11 Impact factor: 7.124
Authors: D P Williams; S B Going; T G Lohman; D W Harsha; S R Srinivasan; L S Webber; G S Berenson Journal: Am J Public Health Date: 1992-03 Impact factor: 9.308
Authors: Asheley Cockrell Skinner; Sophie N Ravanbakht; Joseph A Skelton; Eliana M Perrin; Sarah C Armstrong Journal: Pediatrics Date: 2018-03 Impact factor: 7.124
Authors: George J Schwartz; Michael F Schneider; Paula S Maier; Marva Moxey-Mims; Vikas R Dharnidharka; Bradley A Warady; Susan L Furth; Alvaro Muñoz Journal: Kidney Int Date: 2012-08 Impact factor: 10.612
Authors: Emily R Berkman; Kelsey L Richardson; Jonna D Clark; André A S Dick; Mithya Lewis-Newby; Douglas S Diekema; Aaron G Wightman Journal: Pediatr Nephrol Date: 2022-04-29 Impact factor: 3.714
Authors: Amy J Kogon; Jennifer Roem; Michael F Schneider; Mark M Mitsnefes; Babette S Zemel; Bradley A Warady; Susan L Furth; Nancy M Rodig Journal: Pediatr Nephrol Date: 2022-08-26 Impact factor: 3.651