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2014 ; 25
(9
): 2105-11
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Prenatal risk factors for childhood CKD
#MMPMID24744441
Hsu CW
; Yamamoto KT
; Henry RK
; De Roos AJ
; Flynn JT
J Am Soc Nephrol
2014[Sep]; 25
(9
): 2105-11
PMID24744441
show ga
Development of CKD may be programmed prenatally. We sought to determine the
association of childhood CKD with prenatal risk factors, including birth weight,
maternal diabetes mellitus (DM), and maternal overweight/obesity. We conducted a
population-based, case-control study with 1994 patients with childhood CKD (<21
years of age at diagnosis) and 20,032 controls in Washington state. We linked
maternal and infant characteristics in birth records from 1987 to 2008 to
hospital discharge data and used logistic regression analysis to assess the
association of prenatal risk factors with childhood CKD. The prevalence of CKD
was 126.7 cases per 100,000 births. High birth weight and maternal pregestational
DM associated nominally with CKD, with respective crude odds ratios (ORs) of 1.17
(95% confidence interval [95% CI], 1.03 to 1.34) and 1.97 (95% CI, 1.15 to 3.37);
however, adjustment for maternal confounders attenuated these associations to
0.97 (95% CI, 0.79 to 1.21) and 1.19 (95% CI, 0.51 to 2.81), respectively. The
adjusted ORs for CKD associated with other prenatal factors were 2.88 (95% CI,
2.28 to 3.63) for low birth weight, 1.54 (95% CI, 1.13 to 2.09) for maternal
gestational DM, 1.24 (95% CI, 1.05 to 1.48) for maternal overweight, and 1.26
(95% CI, 1.05 to 1.52) for maternal obesity. In subgroup analysis by CKD subtype,
low birth weight and maternal pregestational DM associated significantly with
increased risk of renal dysplasia/aplasia. Low birth weight, maternal gestational
DM, and maternal overweight/obesity associated significantly with obstructive
uropathy. These data suggest that prenatal factors may impact the risk of CKD.
Future studies should aim to determine if modification of these factors could
reduce the risk of childhood CKD.
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