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Author Notes:

Joseph T. Flynn, MD, MS, Division of Nephrology, OC.9.821, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, Phone: 206.987.2524, Fax: 206.987.2636, joseph.flynn@seattlechildrens.org

The authors declare no conflicts of interest.

Subject:

Research Funding:

Funded by the National Institute of Diabetes and Digestive and Kidney Diseases; the National Institute of Child Health and Human Development; and the National Heart, Lung, and Blood Institute ( U01-DK-66143 , U01-DK-66174 , U01DK-082194 , U01-DK-66116 ).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Pediatrics
  • GLOMERULAR-FILTRATION-RATE
  • EARLY-LIFE FACTORS
  • NEPHRON NUMBER
  • RENAL-DISEASE
  • PROSPECTIVE COHORT
  • CHILDHOOD GROWTH
  • CAUSAL INFERENCE
  • RISK-FACTOR
  • WEIGHT
  • AGE

The Effect of Abnormal Birth History on Ambulatory Blood Pressure and Disease Progression in Children with Chronic Kidney Disease

Tools:

Journal Title:

Journal of Pediatrics

Volume:

Volume 165, Number 1

Publisher:

, Pages 154-+

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objective: To examine the associations between abnormal birth history (birth weight <2500 g, gestational age <36 weeks, or small for gestational age), blood pressure (BP), and renal function among 332 participants (97 with abnormal and 235 with normal birth history) in the Chronic Kidney Disease in Children Study, a cohort of children with chronic kidney disease (CKD). Study design: Casual and 24-hour ambulatory BP were obtained. Glomerular filtration rate (GFR) was determined by iohexol disappearance. Confounders (birth and maternal characteristics, socioeconomic status) were used to generate predicted probabilities of abnormal birth history for propensity score matching. Weighted linear and logistic regression models with adjustment for quintiles of propensity scores and CKD diagnosis were used to assess the impact of birth history on BP and GFR. Results: Age at enrollment, percent with glomerular disease, and baseline GFR were similar between the groups. Those with abnormal birth history were more likely to be female, of Black race or Hispanic ethnicity, to have low household income, or part of a multiple birth. Unadjusted BP measurements, baseline GFR, and change in GFR did not differ significantly between the groups; no differences were seen after adjusting for confounders by propensity score matching. Conclusions: Abnormal birth history does not appear to have exerted a significant influence on BP or GFR in this cohort of children with CKD. The absence of an observed association is likely secondary to the dominant effects of underlying CKD and its treatment.

Copyright information:

© 2014 Elsevier Inc. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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