Pediatric Nephrology

, Volume 29, Issue 9, pp 1589–1598 | Cite as

Kidney size and function in a multi-ethnic population-based cohort of school-age children

  • Hanneke Bakker
  • Marjolein N. Kooijman
  • Albert J. van der Heijden
  • Albert Hofman
  • Oscar H. Franco
  • H. Rob Taal
  • Vincent W. V. Jaddoe
Original Article



Subclinical impaired kidney growth and function in childhood may lead to kidney diseases and high blood pressure in adulthood. We assessed the cross-sectional associations of childhood characteristics with kidney size and function in a multi-ethnic cohort.


This study was embedded in a population-based cohort study of 6,397 children with a median age of 6.0 years.Kidney volume, creatinine and cystatin C blood levels, microalbuminuria and blood pressure were measured, and glomerular filtration rate (GFR) was estimated.


Childhood anthropometrics were positively associated with kidney volume, creatinine level and blood pressure (all p < 0.05). We observed ethnic differences in all kidney size and function measures (all p < 0.05). Children with smaller kidneys had higher creatinine and cystatin C blood levels, leading to a lower estimated GFR [difference 5.68 ml/min/1.73 m2 (95 % confidence interval 5.14–6.12) per 1 standard deviation increase in kidney volume]. Larger kidney volume was associated with an increased risk of microalbuminuria.


Childhood kidney volume and function are influenced by body mass index and ethnicity. Kidney volume is related with kidney function but not with blood pressure. These results may help to identify individuals at risk for kidney disease in an early stage.


Anthropometrics Ethnicity Kidney volume Kidney function Blood pressure 



The Generation R study is being conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of Erasmus University Rotterdam; the Municipal Health Service Rotterdam area, Rotterdam; the Rotterdam Homecare Foundation, Rotterdam; the Stichting Trombosedienst & Artsenlaboratorium Rijnmond, Rotterdam. We gratefully acknowledge the contributions of general practitioners, hospitals, midwives and pharmacies in Rotterdam.

Funding sources

The Generation R Study has been made possible by financial support from the Erasmus Medical Center, Rotterdam; Erasmus University Rotterdam and from The Netherlands Organization for Health Research and Development (ZonMw). Additional support was provided by a grant from the Dutch Kidney Foundation (C08.2251). Vincent Jaddoe received an additional VIDI grant from the Netherlands Orgzanization of Scientific Research. Oscar H. Franco works in ErasmusAGE, a center for aging research across the life course funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA. Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA had no role in the design and conduct of the study, in the collection, management, analysis and interpretation of the data and in the preparation, review or approval of the manuscript.

Supplementary material

467_2014_2793_MOESM1_ESM.doc (132 kb)
ESM 1 (DOC 132 kb)
467_2014_2793_MOESM2_ESM.doc (27 kb)
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467_2014_2793_MOESM3_ESM.doc (40 kb)
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467_2014_2793_MOESM4_ESM.doc (32 kb)
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Copyright information

© IPNA 2014

Authors and Affiliations

  • Hanneke Bakker
    • 1
    • 2
    • 3
  • Marjolein N. Kooijman
    • 1
  • Albert J. van der Heijden
    • 3
  • Albert Hofman
    • 2
  • Oscar H. Franco
    • 2
  • H. Rob Taal
    • 2
    • 3
  • Vincent W. V. Jaddoe
    • 1
    • 2
    • 3
    • 4
  1. 1.The Generation R Study GroupErasmus Medical CenterRotterdamThe Netherlands
  2. 2.Department of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Department of PediatricsErasmus Medical CenterRotterdamThe Netherlands
  4. 4.The Generation R Study Group (Na-2915)Erasmus Medical CenterRotterdamThe Netherlands

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