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Author Notes:

Correspondence: Dr. Larry A. Greenbaum, Division of Pediatric Nephrology, Emory University, 2015 Uppergate Drive, NE, Atlanta, GA 30322. Phone: 404-727-5750; Fax: 404-727-8213; Email: lgreen6@emory.edu.

There are no conflicts of interest to disclose.

Subjects:

Research Funding:

The CKiD prospective cohort study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the National Heart, Lung, and Blood Institute, the National Institute of Child Health and Human Development, and the National Institute of Neurologic Disorders and Stroke.

The CKiD study has been supported by participating institutional General Clinical Research Centers and Clinical Translational Research Centers.

Research at Emory is supported in part by PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program and PHS Grant M01 RR0039 from the General Clinical Research Center program, National Institutes of Health, and the National Center for Research Resources.

The CKiD prospective cohort study has clinical coordinating centers (principal investigators) at Children's Mercy Hospital and the University of Missouri–Kansas City (Bradley Warady, MD; U01-DK-66143) and at Johns Hopkins School of Medicine (Susan Furth, MD, Ph.D.; U01-DK-66174), a data coordinating center at Johns Hopkins Bloomberg School of Public Health (Alvaro Muñoz, Ph.D.; U01-DK-66116), and the Central Biochemistry Laboratory at the University of Rochester Medical Center (George J. Schwartz, MD; U01-DK82194).

The Association between Abnormal Birth History and Growth in Children with CKD

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Journal Title:

Clinical Journal of the American Society of Nephrology

Volume:

Volume 6, Number 1

Publisher:

, Pages 14-21

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background and objectives: Poor linear growth is a well described complication of chronic kidney disease (CKD). This study evaluated whether abnormal birth history defined by low birth weight (LBW; <2500 g), prematurity (gestational age <36 weeks), small for gestational age (SGA; birth weight <10th percentile for gestational age), or intensive care unit (ICU) at birth were risk factors for poor growth outcomes in children with CKD. Design, setting, participants, & measurements: Growth outcomes were quantified by age-sex-specific height and weight z-scores during 1393 visits from 426 participants of the Chronic Kidney Disease in Children Study, an observational cohort of children with CKD. Median baseline GFR was 42.9 ml/min per 1.73 m2, 21% had a glomerular diagnosis, and 52% had CKD for ≥90% of their lifetime. Results: A high prevalence of LBW (17%), SGA (14%), prematurity (12%), and ICU after delivery (40%) was observed. Multivariate analyses demonstrated a negative effect of LBW (−0.43 ± 0.14; P < 0.01 for height and −0.37 ± 0.16; P = 0.02 for weight) and of SGA (−0.29 ± 0.16; P = 0.07 for height and −0.41 ± 0.19; P = 0.03 for weight) on current height and weight. In children with glomerular versus nonglomerular diagnoses, the effect of SGA (−1.08 versus −0.18; P = 0.029) on attained weight was more pronounced in children with a glomerular diagnosis. Conclusions: LBW and SGA are novel risk factors for short stature and lower weight percentiles in children with mild to moderate CKD independent of kidney function.

Copyright information:

© 2011 by the American Society of Nephrology

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