Low birth weight, later renal function, and the roles of adulthood blood pressure, diabetes, and obesity in a British birth cohort

Low birth weight has been shown to be associated with later renal function, but it is unclear to what extent this is explained by other established kidney disease risk factors. Here we investigate the roles of diabetes, hypertension, and obesity using data from the Medical Research Council National Survey of Health and Development, a socially stratified sample of 5362 children born in March 1946 in England, Scotland, and Wales, and followed since. The birth weight of 2192 study members with complete data was related to three markers of renal function at age 60–64 (estimated glomerular filtration rate (eGFR) calculated using cystatin C (eGFRcys), eGFR calculated using creatinine and cystatin C (eGFRcr-cys), and the urine albumin–creatinine ratio) using linear regression. Each 1kg lower birth weight was associated with a 2.25ml/min per 1.73m2 (95% confidence interval 0.80–3.71) lower eGFRcys and a 2.13ml/min per 1.73m2 (0.69–3.58) lower eGFRcr-cys. There was no evidence of an association with urine albumin–creatinine ratio. These associations with eGFR were not confounded by socioeconomic position and were not explained by diabetes or hypertension, but there was some evidence that they were stronger in study members who were overweight in adulthood. Thus, our findings highlight the role of lower birth weight in renal disease and suggest that in those born with lower birth weight particular emphasis should be placed on avoiding becoming overweight