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

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; 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.