Longitudinal outcomes of body mass index in overweight and obese children with chronic kidney disease.

Creator(s)

Nancy M. Rodig
Jennifer Roem
Michael F. Schneider
Patricia W. Seo-Mayer
Kimberly J. Reidy
Frederick J. Kaskel
Amy J. Kogon
Susan L. Furth
Bradley A. Warady, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

7-2021

Identifier

DOI: 10.1007/s00467-020-04907-7

Abstract

BACKGROUND: Longitudinal changes in body mass index (BMI) among overweight and obese children with chronic kidney disease (CKD) are not well characterized. We studied longitudinal trajectories and correlates of these trajectories, as results may identify opportunities to optimize health outcomes.

METHODS: Longitudinal changes in age-sex-specific BMI z-scores over 1851 person-years of follow-up were assessed in 524 participants of the Chronic Kidney Disease in Children Study. A total of 353 participants were categorized as normal (BMI > 5th to < 85th percentile), 56 overweight (BMI ≥ 85th to 95th percentile) and 115 obese (BMI ≥ 95th percentile) based on the average of three BMI measurements during the first year of follow-up. Studied covariates included age, sex, race, CKD etiology, corticosteroid usage, household income, and maternal education.

RESULTS: In unadjusted analysis, BMI z-scores decreased over time in elevated BMI groups (overweight: mean = - 0.06 standard deviations (SD) per year, 95% CI: - 0.11, - 0.01; obese: mean = - 0.04 SD per year, 95% CI: - 0.07, - 0.01). Among obese children, only age was associated with change in BMI z-score; children < 6 years had a mean decrease of 0.19 SD during follow-up (95% CI: - 0.30, - 0.09). Socioeconomic factors were not associated with change in BMI.

CONCLUSION: Overweight and obese children with CKD demonstrated a significant annual decline in BMI, though the absolute change was modest. Among obese children, only age < 6 years was associated with significant decline in BMI. Persistence of elevated BMI in older children and adolescents with CKD underscores the need for early prevention and effective intervention.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

36

Issue

7

First Page

1851

Last Page

1860

Keywords

Children; Chronic kidney disease; Elevated body mass index; Longitudinal; Obesity; Overweight

Recommended Citation

Rodig NM, Roem J, Schneider MF, et al. Longitudinal outcomes of body mass index in overweight and obese children with chronic kidney disease. Pediatr Nephrol. 2021;36(7):1851-1860. doi:10.1007/s00467-020-04907-7