Pediatric Nephrology

, 24:1363

Obesity and preterm birth: additive risks in the progression of kidney disease in children

Authors

    • Division of Pediatric Nephrology (M714)University of Miami/Holtz Children’s Hospital
  • Jayanthi Chandar
    • Division of Pediatric Nephrology (M714)University of Miami/Holtz Children’s Hospital
  • Maria M. Rodríguez
    • Division of PathologyUniversity of Miami/Holtz Children’s Hospital
  • Mariana Berho
    • Division of PathologyUniversity of Miami/Holtz Children’s Hospital
  • Wacharee Seeherunvong
    • Division of Pediatric Nephrology (M714)University of Miami/Holtz Children’s Hospital
  • Michael Freundlich
    • Division of Pediatric Nephrology (M714)University of Miami/Holtz Children’s Hospital
  • Gastón Zilleruelo
    • Division of Pediatric Nephrology (M714)University of Miami/Holtz Children’s Hospital
Original Article

DOI: 10.1007/s00467-009-1120-2

Cite this article as:
Abitbol, C.L., Chandar, J., Rodríguez, M.M. et al. Pediatr Nephrol (2009) 24: 1363. doi:10.1007/s00467-009-1120-2

Abstract

Preterm birth is associated with decreased nephron mass and obesity that may impact on kidney disease progression in later life. Our objectives were to examine the relative risks of obesity and preterm birth on the progression of kidney disease in children. In a retrospective cohort study, 80 (44 obese and 36 non-obese) patients with proteinuric kidney disease were studied for disease progression and glomerular histomorphometry. Of the obese, 22 had been born at term (Obese-T) and 22 had been preterm (Obese-PT). Seventeen non-obese children with focal glomerular sclerosis, born at term (NO-FSGS), and 19 non-obese preterm (NO-PT) children, served as controls. Insulin resistance as measured by the homeostatic model assessment (HOMA-IR) was elevated in all obese children. Obese-PT patients had increased risk of renal demise during childhood when compared with Obese-T children [hazard ratio 2.4; 95% Confidence interval (95% CI) 1.1 to 7.1; P = 0.04]. In obese children, although proteinuria often exceeded nephrotic range, average levels of serum albumin remained normal. Preterm patients were more likely to have reduced renal mass (odds ratio 4.7; P = 0.006), but obesity was not a factor. Renal histomorphometry showed glomerulomegaly in obese patients, regardless of birth weight. Obesity and preterm birth appear to impose additive risks for progression of kidney disease in childhood.

Keywords

Low birth weightObesityChronic kidney diseasePrematurityGlomerulomegalyHistomorphometry

Copyright information

© IPNA 2009