Prenatal risk factors for childhood CKD.
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.
['Hsu|Christine W|CW|', 'Yamamoto|Kalani T|KT|', 'Henry|Rohan K|RK|', 'De Roos|Anneclaire J|AJ|', 'Flynn|Joseph T|JT|']
D000293:Adolescent D000328:Adult D001724:Birth Weight D016022:Case-Control Studies D002648:Child D002675:Child, Preschool D016640:Diabetes, Gestational D005260:Female D006801:Humans D007223:Infant D007230:Infant, Low Birth Weight D007231:Infant, Newborn D008297:Male D009765:Obesity D016017:Odds Ratio D050177:Overweight D011247:Pregnancy D011254:Pregnancy in Diabetics D011297:Prenatal Exposure Delayed Effects D015995:Prevalence D051436:Renal Insufficiency, Chronic D012307:Risk Factors D014861:Washington D055815:Young Adult
CKD obstructive uropathy children clinical epidemiology intrauterine growth renal development