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Reduced kidney function and hypertension in adolescents with low birth weight, NHANES 1999–2016

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Abstract

Background

Chronic kidney disease (CKD) is a major health problem, and the risk of CKD and hypertension in children born low birth weight (LBW) is under-recognized. We hypothesized that children born with LBW would have a higher prevalence of reduced kidney function and hypertension.

Methods

Using the National Health and Nutrition Examination Survey (NHANES), we conducted a cross-sectional study to evaluate whether LBW (< 2500 g), very low birth weight (VLBW < 1500 g), and large birth weight (BW) (> 4000 g) were associated with kidney disease using 4 different estimating equations. We used the Counahan–Barratt, updated Schwartz, CKiD-U25, and full age spectrum creatinine-based GFR estimating equations to evaluate associations between a history of LBW/VLBW/large BW and reduced kidney function (eGFR < 90 mL/min/1.73 m2) in children. We also assessed blood pressure (BP) using the old and new pediatric hypertension guidelines.

Results

Our analysis included 6336 children (age 12–15 years) in NHANES representing over 13 million US individuals. Using the updated Schwartz, the prevalence of reduced kidney function was 30.1% (25.2–35.6) for children born with LBW compared to 22.4% (20.5–24.3) in children with normal BW. Equations yielded different estimates of prevalence of reduced kidney function in LBW from 21.5% for Counahan–Barratt to 35.4% for CKiD-U25. Compared to those with normal BW, participants with LBW and VLBW had a 7.2 and 10.3% higher prevalence of elevated BP and a 2.4 and 14.6% higher prevalence of hypertension, respectively.

Conclusions

Children born with LBW are at higher risk of reduced kidney function and hypertension than previously described.

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Data Availability

All the NHANES data used in this study is publically available on https://www.cdc.gov/nchs/nhanes/index.htm.

Abbreviations

CKD:

Chronic kidney disease

eGFR:

Estimated glomerular filtration rate

BP:

Blood pressure

LBW:

Low birth weight

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Acknowledgements

We thank the NHANES participants and the staff for their contributions to this study.

Funding

This study was supported by National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007110-47S1).

Author information

Authors and Affiliations

  1. Pediatric Nephrology, Washington University in St. Louis, MO, St. Louis, USA

    Kaye E. Brathwaite

  2. Division of Nephrology, Department of Internal Medicine, University of Rochester Medical Center, Rochester, NY, USA

    Rebecca V. Levy

  3. Division of Nephrology, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA

    Rebecca V. Levy & George J. Schwartz

  4. UCSF at Zuckerberg San Francisco General Hospital, San Francisco, CA, USA

    Harini Sarathy

  5. Dept. of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Ilir Agalliu & Michal L. Melamed

  6. Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA

    Tanya S. Johns & Michal L. Melamed

  7. Division of Pediatric Nephrology, Department of Pediatrics, Children’s Hospital at Montefiore, Bronx, NY, USA

    Kimberly J. Reidy, Frederick J. Kaskel & Michal L. Melamed

  8. Division of Pediatric Nephrology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA

    Jeffrey J. Fadrowski

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  1. Kaye E. Brathwaite
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Correspondence to Kaye E. Brathwaite.

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Brathwaite, K.E., Levy, R.V., Sarathy, H. et al. Reduced kidney function and hypertension in adolescents with low birth weight, NHANES 1999–2016. Pediatr Nephrol 38, 3071–3082 (2023). https://doi.org/10.1007/s00467-023-05958-2

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