Judit Bassols1, Abel López-Bermejo2,3,4, Pierluigi Marzuillo5, Gemma Carreras-Badosa2, José-María Martínez-Calcerrada6, Stefano Guarino7, Pier Luigi Palma7, Delfina Petrone7, Emanuele Miraglia Del Giudice7. 1. Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190, Salt, Spain. jbassols@idibgi.org. 2. Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190, Salt, Spain. 3. Pediatric Endocrinology, Dr. Josep Girona Hospital, 17007, Girona, Spain. 4. Department of Medical Sciences, University of Girona, 17003, Girona, Spain. 5. Department of Woman, Child and of General and Specialized Surgery, Università Degli Studi Della Campania "Luigi Vanvitelli", Via Luigi De Crecchio 2, 80138, Naples, Italy. pierluigi.marzuillo@unicampania.it. 6. Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190, Salt, Spain. 7. Department of Woman, Child and of General and Specialized Surgery, Università Degli Studi Della Campania "Luigi Vanvitelli", Via Luigi De Crecchio 2, 80138, Naples, Italy.
Abstract
BACKGROUND: We evaluated the diagnostic performance of height-, age- and body surface area (BSA)-based kidney length (KL) percentiles in the identification of at least one small kidney (KL < 3rd) and in the prediction of reduced estimated glomerular filtration rate (eGFR) and/or elevated blood pressure (BP) in children with and without overweight (OW)/obesity(OB). METHODS: In this cross-sectional study, 744 apparently healthy children (mean age 8.3 years) were recruited in a primary care setting. Clinical data were collected, and serum creatinine and KL were measured. Height-, age- and BSA-based percentiles of KL were calculated and the association of at least one small kidney per subject with reduced eGFR and/or elevated BP was explored by logistic regression. RESULTS: Two hundred fifty-seven out of seven hundred forty-four (34.5%) subjects were OW/OB and 127 (17.1%) had reduced eGFR or elevated BP. In separate analyses in children with OW/OB, the KL percentiles calculated on the basis of BSA were lower compared with height- and age-based KL percentiles. Consequently, the prevalence of a small kidney was significantly higher when evaluating percentiles of KL based on BSA compared with other percentiles. In logistic regression analysis, a small kidney was significantly associated with reduced eGFR and/or elevated BP only when using height-based KL percentiles. The KL percentiles according to BSA for the ideal weight (iBSA) showed similar performance compared with height-based percentiles. No differences in the diagnostic performance of different percentiles were found in children with normal weight. CONCLUSIONS: BSA-based percentiles underestimate KL in children with OW/OB. In these subjects, the use of height-based or iBSA-based percentiles should be preferred. A higher resolution version of the Graphical abstract is available as Supplementary information.
BACKGROUND: We evaluated the diagnostic performance of height-, age- and body surface area (BSA)-based kidney length (KL) percentiles in the identification of at least one small kidney (KL < 3rd) and in the prediction of reduced estimated glomerular filtration rate (eGFR) and/or elevated blood pressure (BP) in children with and without overweight (OW)/obesity(OB). METHODS: In this cross-sectional study, 744 apparently healthy children (mean age 8.3 years) were recruited in a primary care setting. Clinical data were collected, and serum creatinine and KL were measured. Height-, age- and BSA-based percentiles of KL were calculated and the association of at least one small kidney per subject with reduced eGFR and/or elevated BP was explored by logistic regression. RESULTS: Two hundred fifty-seven out of seven hundred forty-four (34.5%) subjects were OW/OB and 127 (17.1%) had reduced eGFR or elevated BP. In separate analyses in children with OW/OB, the KL percentiles calculated on the basis of BSA were lower compared with height- and age-based KL percentiles. Consequently, the prevalence of a small kidney was significantly higher when evaluating percentiles of KL based on BSA compared with other percentiles. In logistic regression analysis, a small kidney was significantly associated with reduced eGFR and/or elevated BP only when using height-based KL percentiles. The KL percentiles according to BSA for the ideal weight (iBSA) showed similar performance compared with height-based percentiles. No differences in the diagnostic performance of different percentiles were found in children with normal weight. CONCLUSIONS: BSA-based percentiles underestimate KL in children with OW/OB. In these subjects, the use of height-based or iBSA-based percentiles should be preferred. A higher resolution version of the Graphical abstract is available as Supplementary information.
Authors: Andrew S Levey; Kai-Uwe Eckardt; Nijsje M Dorman; Stacy L Christiansen; Ewout J Hoorn; Julie R Ingelfinger; Lesley A Inker; Adeera Levin; Rajnish Mehrotra; Paul M Palevsky; Mark A Perazella; Allison Tong; Susan J Allison; Detlef Bockenhauer; Josephine P Briggs; Jonathan S Bromberg; Andrew Davenport; Harold I Feldman; Denis Fouque; Ron T Gansevoort; John S Gill; Eddie L Greene; Brenda R Hemmelgarn; Matthias Kretzler; Mark Lambie; Pascale H Lane; Joseph Laycock; Shari E Leventhal; Michael Mittelman; Patricia Morrissey; Marlies Ostermann; Lesley Rees; Pierre Ronco; Franz Schaefer; Jennifer St Clair Russell; Caroline Vinck; Stephen B Walsh; Daniel E Weiner; Michael Cheung; Michel Jadoul; Wolfgang C Winkelmayer Journal: Kidney Int Date: 2020-03-09 Impact factor: 10.612
Authors: A Carrascosa; J M Fernández; C Fernández; A Ferrández; J P López-Siguero; E Sánchez; B Sobradillo; D Yeste Journal: Endocrinol Nutr Date: 2009-01-07
Authors: Łukasz Obrycki; Jędrzej Sarnecki; Marianna Lichosik; Małgorzata Sopińska; Małgorzata Placzyńska; Małgorzata Stańczyk; Julia Mirecka; Agnieszka Wasilewska; Maciej Michalski; Weronika Lewandowska; Tadeusz Dereziński; Michał Pac; Natalia Szwarc; Karol Annusewicz; Viktoriia Rekuta; Karolis Ažukaitis; Andrius Čekuolis; Aldona Wierzbicka-Rucińska; Augustina Jankauskiene; Bolesław Kalicki; Katarzyna Jobs; Marcin Tkaczyk; Janusz Feber; Mieczysław Litwin Journal: Pediatr Nephrol Date: 2021-10-16 Impact factor: 3.651