Association between low birth weight and childhood-onset chronic kidney disease in Japan: a combined analysis of a nationwide survey for paediatric chronic kidney disease and the National Vital Statistics Report

Daishi Hirano, Kenji Ishikura, Osamu Uemura, Shuichi Ito, Naohiro Wada, Motoshi Hattori, Yasuo Ohashi, Yuko Hamasaki, Ryojiro Tanaka, Koichi Nakanishi, Tetsuji Kaneko, Masataka Honda
Nephrology, Dialysis, Transplantation 2016, 31 (11): 1895-1900

BACKGROUND: Although numerous epidemiological surveys performed across several continents and ethnic groups have linked low birth weight (LBW) to increased risk of chronic kidney disease (CKD) in adulthood, the effects of birth weight and prematurity on development of CKD in childhood have not been clearly established.

METHODS: Data on sex, LBW incidence and gestational age were compared between paediatric CKD cases and a control group. Paediatric CKD cases were obtained from a nationwide survey conducted by the Pediatric CKD Study Group in Japan. The population attributable fraction was calculated to evaluate the effects of reducing the prevalence of LBW infants (LBWI).

RESULTS: Of 447 individuals born between 1993 and 2010 that fulfilled the eligibility criteria, birth weight data were obtained for 381 (85.2%) (231 boys and 150 girls), 106 (27.8%) of whom were LBWI. The proportion of LBWI in the general population during the same period was much lower (8.6%). Therefore, the risk ratio (RR) for paediatric CKD was significantly higher in the LBW group [crude RR: 4.10; 95% confidence interval (CI) 3.62-5.01], and the overall impact on paediatric CKD for removal of LBW amounted to 21.1% (95% CI 16.0-26.1%). In addition, 82 patients (21.9%) with paediatric CKD were born prematurely (before 37 weeks of gestation), and as with LBW, a strong correlation was observed between prematurity and CKD (RR: 4.73; 95% CI 3.91-5.73).

CONCLUSIONS: Both birth weight and gestational age were strongly associated with childhood-onset CKD in this study.

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