Skip to main content
Erschienen in: Pediatric Nephrology 7/2009

01.07.2009 | Original Article

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

verfasst von: Carolyn L. Abitbol, Jayanthi Chandar, Maria M. Rodríguez, Mariana Berho, Wacharee Seeherunvong, Michael Freundlich, Gastón Zilleruelo

Erschienen in: Pediatric Nephrology | Ausgabe 7/2009

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Hedley A, Ogden CL, Johnson CL, Carrol MD, Curtin LR, Flegal KM (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291:2847–2850CrossRef Hedley A, Ogden CL, Johnson CL, Carrol MD, Curtin LR, Flegal KM (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291:2847–2850CrossRef
2.
Zurück zum Zitat Praga M, Hernández E, Herrero JC, Morales E, Revilla Y, Diax-Gonzalez R, Rodicio JL (2000) Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int 58:2111–2118CrossRef Praga M, Hernández E, Herrero JC, Morales E, Revilla Y, Diax-Gonzalez R, Rodicio JL (2000) Influence of obesity on the appearance of proteinuria and renal insufficiency after unilateral nephrectomy. Kidney Int 58:2111–2118CrossRef
3.
Zurück zum Zitat Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD (2001) Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 59:1498–1509CrossRef Kambham N, Markowitz GS, Valeri AM, Lin J, D’Agati VD (2001) Obesity-related glomerulopathy: an emerging epidemic. Kidney Int 59:1498–1509CrossRef
4.
Zurück zum Zitat Praga M, Hernandez E, Morales E, Campos AP, Valero MA, Martinez MA, Leon M (2001) Clinical features and longterm outcome of obesity-associated focal glomerulosclerosis. Nephrol Dial Transplant 16:1790–1798CrossRef Praga M, Hernandez E, Morales E, Campos AP, Valero MA, Martinez MA, Leon M (2001) Clinical features and longterm outcome of obesity-associated focal glomerulosclerosis. Nephrol Dial Transplant 16:1790–1798CrossRef
5.
Zurück zum Zitat Adelman RD, Restaino JG, Alon US, Blowley DL (2001) Proteinuria and focal segmental glomerulosclerosis in severely obese adolescents. J Pediatr 138:482–485CrossRef Adelman RD, Restaino JG, Alon US, Blowley DL (2001) Proteinuria and focal segmental glomerulosclerosis in severely obese adolescents. J Pediatr 138:482–485CrossRef
6.
Zurück zum Zitat Bonnet F, Deprele C, Sassolas A, Moulin P, Alamartine E, Berthezene F, Berthoux F (2001) Excessive body weight as a new independent risk factor for clinical and pathological progression in IgA nephritis. Am J Kidney Dis 37:720–727CrossRef Bonnet F, Deprele C, Sassolas A, Moulin P, Alamartine E, Berthezene F, Berthoux F (2001) Excessive body weight as a new independent risk factor for clinical and pathological progression in IgA nephritis. Am J Kidney Dis 37:720–727CrossRef
7.
Zurück zum Zitat González E, Gutiérrez E, Morales E, Hernandez E, Andres A, Bello I, Diaz-Gonzalez R, Leiva O, Praga M (2005) Factors influencing the progression of renal damage in patients with unilateral renal agenesis and remnant kidney. Kidney Int 168:263–270CrossRef González E, Gutiérrez E, Morales E, Hernandez E, Andres A, Bello I, Diaz-Gonzalez R, Leiva O, Praga M (2005) Factors influencing the progression of renal damage in patients with unilateral renal agenesis and remnant kidney. Kidney Int 168:263–270CrossRef
8.
Zurück zum Zitat Ahmed MH, Khalil AA (2007) Obesity-related glomerulopathy: another nail in the coffin of the epidemic of end-stage renal disease. J Clin Pathol 60:582CrossRef Ahmed MH, Khalil AA (2007) Obesity-related glomerulopathy: another nail in the coffin of the epidemic of end-stage renal disease. J Clin Pathol 60:582CrossRef
9.
Zurück zum Zitat Rea DJ, Heimbach JK, Grande JP, Textor SC, Taler SJ, Prieto M, Larson TS, Cosio FG, Stegall MD (2006) Glomerular volume and renal histology in obese and non-obese living kidney donors. Kidney Int 70:1636–1641CrossRef Rea DJ, Heimbach JK, Grande JP, Textor SC, Taler SJ, Prieto M, Larson TS, Cosio FG, Stegall MD (2006) Glomerular volume and renal histology in obese and non-obese living kidney donors. Kidney Int 70:1636–1641CrossRef
10.
Zurück zum Zitat Tomaszewski M, Charchar FJ, Maric C, McClure C, Crawford L, Grzeszczak W, Sattar N, Zulowska-Szczechowska E, Dominiczak AF, Luyckx VA (2007) Glomerular hyperfiltration: a marker of metabolic risk. Kidney Int 71:816–821CrossRef Tomaszewski M, Charchar FJ, Maric C, McClure C, Crawford L, Grzeszczak W, Sattar N, Zulowska-Szczechowska E, Dominiczak AF, Luyckx VA (2007) Glomerular hyperfiltration: a marker of metabolic risk. Kidney Int 71:816–821CrossRef
11.
Zurück zum Zitat Mañalich R, Reyes L, Herrera M, Melendi C, Fundora I (2000) Relationship between weight at birth and number and size of renal glomeruli in humans: a histomorphometric study. Kidney Int 58:770–773CrossRef Mañalich R, Reyes L, Herrera M, Melendi C, Fundora I (2000) Relationship between weight at birth and number and size of renal glomeruli in humans: a histomorphometric study. Kidney Int 58:770–773CrossRef
12.
Zurück zum Zitat Rodriguez MM, Gomez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25CrossRef Rodriguez MM, Gomez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE (2004) Histomorphometric analysis of postnatal glomerulogenesis in extremely preterm infants. Pediatr Dev Pathol 7:17–25CrossRef
13.
Zurück zum Zitat Vikse BE, Irgens LM, Leivestad T, Hallan S, Iversen BM (2008) Low birth weight increases risk for end stage renal disease. J Am Soc Nephrol 19:151–157CrossRef Vikse BE, Irgens LM, Leivestad T, Hallan S, Iversen BM (2008) Low birth weight increases risk for end stage renal disease. J Am Soc Nephrol 19:151–157CrossRef
14.
Zurück zum Zitat Hershkovitz D, Burbea Z, Skorecki K, Brenner BM (2007) Fetal programming of adult kidney disease: cellular and molecular mechanisms. Clin J Am Soc Nephrol 2:334–342CrossRef Hershkovitz D, Burbea Z, Skorecki K, Brenner BM (2007) Fetal programming of adult kidney disease: cellular and molecular mechanisms. Clin J Am Soc Nephrol 2:334–342CrossRef
15.
Zurück zum Zitat Singh GR, Hoy WE (2004) Kidney volume, blood pressure and albuminuria: findings in an Australian Aboriginal community. Am J Kidney Dis 43:254–259CrossRef Singh GR, Hoy WE (2004) Kidney volume, blood pressure and albuminuria: findings in an Australian Aboriginal community. Am J Kidney Dis 43:254–259CrossRef
16.
Zurück zum Zitat Narva AS (2003) The spectrum of kidney disease in American Indians. Kidney Int 83 [Suppl]:53–57 Narva AS (2003) The spectrum of kidney disease in American Indians. Kidney Int 83 [Suppl]:53–57
17.
Zurück zum Zitat Lackland DT, Bendal HE, Osmond C, Egan BM, Barker DJP (2000) Low birth weight contributes to the high rates of early onset chronic renal failure on the southeast United States. Arch Intern Med 160:1472–1476CrossRef Lackland DT, Bendal HE, Osmond C, Egan BM, Barker DJP (2000) Low birth weight contributes to the high rates of early onset chronic renal failure on the southeast United States. Arch Intern Med 160:1472–1476CrossRef
18.
Zurück zum Zitat Hughson M, Farris AB 3rd, Douglas-Denton R, Hoy WE, Bertram JF (2003) Glomerular number and size in autopsy kidneys: the relationship to birth weight. Kidney Int 63:2113–2122CrossRef Hughson M, Farris AB 3rd, Douglas-Denton R, Hoy WE, Bertram JF (2003) Glomerular number and size in autopsy kidneys: the relationship to birth weight. Kidney Int 63:2113–2122CrossRef
19.
Zurück zum Zitat Abitbol CL, Bauer CR, Montané B, Chandar J, Duara S, Zilleruelo G (2003) Long-term follow-up of extremely low birth weight infants with neonatal renal failure. Pediatr Nephrol 18:887–893CrossRef Abitbol CL, Bauer CR, Montané B, Chandar J, Duara S, Zilleruelo G (2003) Long-term follow-up of extremely low birth weight infants with neonatal renal failure. Pediatr Nephrol 18:887–893CrossRef
20.
Zurück zum Zitat Regan FM, Cutfield WS, Jefferies C, Robinson E, Hofman PL (2006) The impact of early nutrition in premature infants on later childhood insulin sensitivity and growth. Pediatrics 118:1943–1949CrossRef Regan FM, Cutfield WS, Jefferies C, Robinson E, Hofman PL (2006) The impact of early nutrition in premature infants on later childhood insulin sensitivity and growth. Pediatrics 118:1943–1949CrossRef
21.
Zurück zum Zitat Hovi P, Andersson S, Eriksson JG, Järvenpää AL, Strang-Karlsson S, Mäkitie O, Kajantie E (2007) Glucose regulation in young adults with very low birth weight. N Engl J Med 356:2053–2063CrossRef Hovi P, Andersson S, Eriksson JG, Järvenpää AL, Strang-Karlsson S, Mäkitie O, Kajantie E (2007) Glucose regulation in young adults with very low birth weight. N Engl J Med 356:2053–2063CrossRef
22.
Zurück zum Zitat Jimenez-Chillaron JC, Patti ME (2007) To catch up or not to catch up: is this the question? Lessons from animal models. Curr Opin Endocrinol Diabetes Obes 14:23–29CrossRef Jimenez-Chillaron JC, Patti ME (2007) To catch up or not to catch up: is this the question? Lessons from animal models. Curr Opin Endocrinol Diabetes Obes 14:23–29CrossRef
23.
Zurück zum Zitat Wahba IM, Mak RH (2007) Obesity and obesity-initiated metabolic syndrome: mechanistic links to chronic kidney disease. Clin J Am Soc Nephrol 2:550–562CrossRef Wahba IM, Mak RH (2007) Obesity and obesity-initiated metabolic syndrome: mechanistic links to chronic kidney disease. Clin J Am Soc Nephrol 2:550–562CrossRef
24.
Zurück zum Zitat Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374CrossRef Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350:2362–2374CrossRef
25.
Zurück zum Zitat Abitbol CL, Chandar J, Onder AM, Nwobi O, Montane B, Zilleruelo G (2006) Profiling proteinuria in pediatric patients. Pediatr Nephrol 21:995–1002CrossRef Abitbol CL, Chandar J, Onder AM, Nwobi O, Montane B, Zilleruelo G (2006) Profiling proteinuria in pediatric patients. Pediatr Nephrol 21:995–1002CrossRef
26.
Zurück zum Zitat Frisancho AR (1993) Anthropometric standards for the assessment of growth and nutritional status. University of Michigan Press, Ann Arbor, pp 31–36 Frisancho AR (1993) Anthropometric standards for the assessment of growth and nutritional status. University of Michigan Press, Ann Arbor, pp 31–36
27.
Zurück zum Zitat Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109:45–60CrossRef Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL (2002) Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 109:45–60CrossRef
28.
Zurück zum Zitat National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 114:555–576CrossRef National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The Fourth Report on the Diagnosis, Evaluation and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics 114:555–576CrossRef
30.
Zurück zum Zitat Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263PubMed Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263PubMed
31.
Zurück zum Zitat Rosenbaum DM, Korngold E, Teele RL (1983) Sonographic assessment of renal length in normal children. AJR Am J Roentgenol 142:467–469CrossRef Rosenbaum DM, Korngold E, Teele RL (1983) Sonographic assessment of renal length in normal children. AJR Am J Roentgenol 142:467–469CrossRef
32.
Zurück zum Zitat Dinkel E, Ertel M, Dittrich M, Peters H, Berres M, Schulte-Wissermann H (1985) Kidney size in childhood: sonographic growth charts for kidney length and volume. Pediatr Radiol 15:38–43CrossRef Dinkel E, Ertel M, Dittrich M, Peters H, Berres M, Schulte-Wissermann H (1985) Kidney size in childhood: sonographic growth charts for kidney length and volume. Pediatr Radiol 15:38–43CrossRef
33.
Zurück zum Zitat Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRef Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRef
34.
Zurück zum Zitat Chen HM, Liu ZH, Zeng CH, Li SJ, Wang QW, Li LS (2006) Podocyte lesions in patients with obesity-related glomerulopathy. Am J Kidney Dis 48:772–779CrossRef Chen HM, Liu ZH, Zeng CH, Li SJ, Wang QW, Li LS (2006) Podocyte lesions in patients with obesity-related glomerulopathy. Am J Kidney Dis 48:772–779CrossRef
35.
Zurück zum Zitat Hoy WE, Samuel T, Hughson MD, Nicol JL, Bertram JF (2006) How many glomerular profiles must be measured to obtain reliable estimates of mean glomerular areas in human renal biopsies? J Am Soc Nephrol 17:556–563CrossRef Hoy WE, Samuel T, Hughson MD, Nicol JL, Bertram JF (2006) How many glomerular profiles must be measured to obtain reliable estimates of mean glomerular areas in human renal biopsies? J Am Soc Nephrol 17:556–563CrossRef
36.
Zurück zum Zitat Hodgin JB, Rasoulpour M, Markowitz GS, D’Agati VD (2009) Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 4:71-76CrossRef Hodgin JB, Rasoulpour M, Markowitz GS, D’Agati VD (2009) Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol 4:71-76CrossRef
37.
Zurück zum Zitat Simonetti GD, Raio L, Surbek D, Nelle M, Frey FJ, Mohaupt MG (2008) Salt sensitivity of children with low birth weight. Hypertension 52:625–630CrossRef Simonetti GD, Raio L, Surbek D, Nelle M, Frey FJ, Mohaupt MG (2008) Salt sensitivity of children with low birth weight. Hypertension 52:625–630CrossRef
38.
Zurück zum Zitat Irving RJ, Belton NR, Elton RA, Walker BR (2000) Adult cardiovascular risk factors in premature babies. Lancet 355:2135–2136CrossRef Irving RJ, Belton NR, Elton RA, Walker BR (2000) Adult cardiovascular risk factors in premature babies. Lancet 355:2135–2136CrossRef
39.
Zurück zum Zitat Keijzer-Veen MG, Schrevel M, Finken MJ, Dekker FW, Nauta J, Hille ET, Frolich M, van der Heijden BJ (2005) Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 16:2762–2768CrossRef Keijzer-Veen MG, Schrevel M, Finken MJ, Dekker FW, Nauta J, Hille ET, Frolich M, van der Heijden BJ (2005) Microalbuminuria and lower glomerular filtration rate at young adult age in subjects born very premature and after intrauterine growth retardation. J Am Soc Nephrol 16:2762–2768CrossRef
Metadaten
Titel
Obesity and preterm birth: additive risks in the progression of kidney disease in children
verfasst von
Carolyn L. Abitbol
Jayanthi Chandar
Maria M. Rodríguez
Mariana Berho
Wacharee Seeherunvong
Michael Freundlich
Gastón Zilleruelo
Publikationsdatum
01.07.2009
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Nephrology / Ausgabe 7/2009
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-009-1120-2

Weitere Artikel der Ausgabe 7/2009

Pediatric Nephrology 7/2009 Zur Ausgabe

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.