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Kidney Week

Abstract: PO2294

Children with a History of Low Birth Weight (LBW) Show Greater Reduction in Kidney Function Than Previously Described Using the Updated Schwartz Equation

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Brathwaite, Kaye E., Children's Hospital at Montefiore, Bronx, New York, United States
  • Levy, Rebecca, Montefiore Medical Center, Bronx, New York, United States
  • Sarathy, Harini, University of California San Francisco, San Francisco, California, United States
  • Agalliu, Ilir, Yeshiva University Albert Einstein College of Medicine, Bronx, New York, United States
  • Johns, Tanya S., Montefiore Medical Center, Bronx, New York, United States
  • Reidy, Kimberly J., Children's Hospital at Montefiore, Bronx, New York, United States
  • Kaskel, Frederick J., Children's Hospital at Montefiore, Bronx, New York, United States
  • Melamed, Michal L., Montefiore Medical Center, Bronx, New York, United States
Background

There is a higher risk of reduced kidney function in adults born with LBW (birthweight<2500g). A study using the Counahan-Barrat (CB) eGFR estimation described a modest risk increase in adolescents with LBW. However the CB equation is only validated in children with CKD and underestimates the burden of CKD. Utilizing the updated Schwartz equation, a more sensitive calculation of eGFR validated in healthy children, we sought to assess the prevalence of reduced kidney function in adolescents born with LBW.

Methods

We performed a cross sectional analysis of children aged 12-15 from the National Health and Nutrition Examination Survey from 1999-2016. Reduced kidney function was defined as eGFR <90mL//min/1.73m2. Participant characteristics were described as weighted sample means and proportions. We constructed logistic regression models adjusted for important sociodemographic factors to evaluate the association of LBW with reduced kidney function.

Results

A total of 6345 individuals were analyzed, representing 13,760,132 adolescents of whom 8% had a history of LBW. Of those born with LBW, the mean age was 13.6 years, 49% were males, 49% were white, 25% were black, 19% were Mexican-American, and 7% were other race. A higher percentage of children with LBW was seen in worse poverty groups. Mean eGFRs in those born LBW were 103 and 107mL/min/1.73m2 using the updated Schwartz and CB equation, respectively. The prevalence of reduced kidney function in those born LBW was greater using the updated Schwartz equation compared to the CB equation, 30% vs 21.4%. The updated Schwartz equation showed a greater association of LBW and reduced kidney function OR 1.51 (95% CI 1.16-1.97) compared to the CB equation, OR 1.44 (95% CI 1.06-1.96). In an adjusted analysis, the odds of reduced kidney function in adolescents with LBW remained significant OR 1.46 (95% CI 1.1-1.97 using Schwartz but not the CB equation.

Conclusion

A higher prevalence of reduced kidney function was seen in children born with LBW utilizing updated Schwartz compared to the CB equation. The higher risk was sustained in adjusted analyses. These findings may support development of guidelines for CKD screening during long term follow up in the pediatric population with LBW.