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Pediatric nephrology patients are overweight: 20 years' experience in a single Canadian tertiary pediatric nephrology clinic

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Abstract

Background

Obesity is an independent risk factor for chronic kidney disease (CKD). We compared the body composition of pediatric nephrology patients with that of the general child population over 2 decades.

Methods

About 4,959 patients above 2 years of age (mean: 9.6 ± 4.5) were referred to a tertiary pediatric nephrology clinic from 1985 to 2006. In 3,422 patients (69.0% with the same mean age) there were sufficient data to analyze body composition, expressed as body mass index (BMI) Z-score and calculated on the basis of normal data taken from the National (USA) Center for Health Statistics (2000).

Results

Hematuria (21.68%), recurrent urinary tract infections (16.09%), proteinuria (13.95%) and hypertension (8.27%) were the most common referral diagnoses. Mean BMI Z-score of the pediatric nephrology patients increased significantly from 0.29 ± 1.07 during the years 1985–1991 to 0.44 ± 1.27 in 1992–1999 and 0.87 ± 1.70 in 2000–2006 (P < 0.0001, ANOVA). Whereas the rate of the increase in BMI Z-score was not statistically different from that seen in the normal population, the young nephrology patients had over the entire time consistently significantly higher BMI Z-scores (average +0.72) than the comparable normal USA data. Several disease groups with potential for development of CKD had higher BMI Z-scores than found in the age- and sex-adjusted control data.

Conclusions

The increased rate of obesity in our studied population suggests that pediatric nephrology patients are at even greater risk for developing CKD later in life than could be predicted from their renal disease only. We recommend therapeutic intervention to address this potentially modifiable risk factor.

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Acknowledgments

This study was funded by grants to Peter McLaine and Guido Filler by the CHEO Research Institute. Mrs. Elaine Orrbine and Dr. Peter McLaine initiated the database in conjunction with a national initiative of the Canadian Paediatric Kidney Disease Research Centre (CPKDRC). We express our gratitude to all other pediatric nephrologists (Dr. Norman Wolfish, Dr. Janusz Feber and Dr. Gabrielle Weiler) and the fellows and residents at CHEO who filled-out the data collection documents. We thank Darlene Poulin for her endless patience with the data collection after 2003 and her valuable editing of the English language. We thank Dr. Kathy Speechley for her valuable advice.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Nephrology, Children’s Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, ON, Canada

    Guido Filler, Sílvia Mansur Reimão, Anusha Kathiravelu & Janusz Feber

  2. Department of Pediatrics, Children’s Hospital of Western Ontario, 800 Commissioners Road East, Room E6-104, N6A 5W9, London, ON, Canada

    Guido Filler & Joanne Grimmer

  3. Department of Pediatrics, Schulich School of Medicine & Dentistry, London, ON, Canada

    Guido Filler & Joanne Grimmer

  4. Division of Pediatric Nephrology, Shaare Zedek Medical Centre, Jerusalem, Israel

    Alfred Drukker

Authors
  1. Guido Filler
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  2. Sílvia Mansur Reimão
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  3. Anusha Kathiravelu
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  4. Joanne Grimmer
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  5. Janusz Feber
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  6. Alfred Drukker
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Corresponding author

Correspondence to Guido Filler.

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Filler, G., Reimão, S.M., Kathiravelu, A. et al. Pediatric nephrology patients are overweight: 20 years' experience in a single Canadian tertiary pediatric nephrology clinic. Int Urol Nephrol 39, 1235–1240 (2007). https://doi.org/10.1007/s11255-007-9258-y

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  • DOI: https://doi.org/10.1007/s11255-007-9258-y

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