The Association between Abnormal Birth History and Growth in Children with CKD

Background and objectives: Poor linear growth is a well described complication of chronic kidney disease (CKD). This study evaluated whether abnormal birth history defined by low birth weight (LBW; <2500 g), prematurity (gestational age <36 weeks), small for gestational age (SGA; birth weight <10th percentile for gestational age), or intensive care unit (ICU) at birth were risk factors for poor growth outcomes in children with CKD. Design, setting, participants, & measurements: Growth outcomes were quantified by age-sex-specific height and weight z-scores during 1393 visits from 426 participants of the Chronic Kidney Disease in Children Study, an observational cohort of children with CKD. Median baseline GFR was 42.9 ml/min per 1.73 m2, 21 % had a glomerular diagnosis, and 52 % had CKD for>90 % of their lifetime. Results: A high prevalence of LBW (17%), SGA (14%), prematurity (12%), and ICU after delivery (40%) was observed. Multivariate analyses demonstrated a negative effect of LBW (0.43 0.14; P < 0.01 for height and 0.37 0.16; P 0.02 for weight) and of SGA (0.29 0.16; P 0.07 for height and 0.41 0.19; P 0.03 for weight) on current height and weight. In children with glomerular versus nonglomerular diagnoses, the effect of SGA (1.08 versus 0.18; P 0.029) on attained weight was more pronounced in children with a glomerular diagnosis. Conclusions: LBW and SGA are novel risk factors for short stature and lower weight percentiles in children with mild t