Childhood obesity; Creatinine; Lifestyle intervention; Pediatrics; eGFR; Adolescent; Child; Female; Humans; Male; Body Mass Index; Kidney Function Tests/methods; Life Style; Longitudinal Studies; Overweight/therapy; Overweight/physiopathology; Creatinine/blood; Glomerular Filtration Rate; Kidney/physiopathology; Pediatric Obesity/therapy; Pediatric Obesity/physiopathology; Pediatric Obesity/blood; Renal Insufficiency, Chronic/therapy; Renal Insufficiency, Chronic/physiopathology; Renal Insufficiency, Chronic/blood; Pediatrics, Perinatology and Child Health; Nephrology
Abstract :
[en] [en] BACKGROUND: Children with overweight and obesity are at risk for developing chronic kidney disease (CKD). During lifestyle adjustment, the first step in the treatment of childhood obesity, body proportions are likely to change. The aim of this study was to examine how lifestyle intervention affects creatinine-based kidney function estimation in children with overweight and obesity.
METHODS: This longitudinal lifestyle intervention study included 614 children with overweight and obesity (mean age 12.17 ± 3.28 years, 53.6% female, mean BMI z-score 3.32 ± 0.75). Loss to follow-up was present: 305, 146, 70, 26, and 10 children were included after 1, 2, 3, 4, and 5 (about yearly) follow-up visits, respectively. Serum creatinine (SCr) was rescaled using Q-age and Q-height polynomials.
RESULTS: At baseline, 95-97% of the children had a SCr/Q-height and SCr/Q-age in the normal reference range [0.67-1.33]. SCr/Q significantly increased each (about yearly) follow-up visit, and linear mixed regression analyses demonstrated slopes between 0.01 and 0.04 (corresponding with eGFR FAS reduction of 1.1-4.1 mL/min/1.73 m2) per visit. BMI z-score reduced in both sexes and this reduction was significantly higher in males. No correlation between change in rescaled SCr and BMI z-score reduction could be demonstrated.
CONCLUSIONS: Rescaled serum creatinine (SCr/Q) slightly increases during multidiscipline lifestyle intervention in this cohort of children with overweight and obesity. This effect seems to be independent from change in BMI z-score. Whether this minor decrease in estimated kidney function has clinical consequences in the long term remains to be seen in trials with a longer follow-up period.
CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov; Registration Number: NCT02091544.
Disciplines :
Urology & nephrology
Author, co-author :
van Dam, Mark J C M; Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Pediatrics, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center +, MosaKids Children's Hospital, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. mark.van.dam@mumc.nl
Pottel, Hans ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
Delanaye, Pierre ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale ; Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
Vreugdenhil, Anita C E; Centre for Overweight Adolescent and Children's Healthcare (COACH), Department of Pediatrics, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center +, MosaKids Children's Hospital, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands
Language :
English
Title :
The evaluation of kidney function estimation during lifestyle intervention in children with overweight and obesity.
Publication date :
November 2024
Journal title :
Pediatric Nephrology
ISSN :
0931-041X
eISSN :
1432-198X
Publisher :
Springer Science and Business Media Deutschland GmbH, Germany
C.P. Kovesdy S.L. Furth C. Zoccali Obesity and kidney disease: hidden consequences of the epidemic Pediatr Nephrol 2017 32 537 545 10.1007/s00467-017-3595-6 28188438
S. Groen In 't Woud N. Roeleveld R. Westland K.Y. Renkema M.G. Steffens V. Gracchi M.R. Lilien J.A.E. van Wijk W.F.J. Feitz M.F. Schreuder L.F.M. van der Zanden Uncovering risk factors for kidney injury in children with a solitary functioning kidney Kidney Int 2022 103 156 165 10.1016/j.kint.2022.09.028 36374825
K.L. Nowak Z. You B. Gitomer G. Brosnahan V.E. Torres A.B. Chapman R.D. Perrone T.I. Steinman K.Z. Abebe F.F. Rahbari-Oskoui A.S.L. Yu P.C. Harris K.T. Bae M. Hogan D. Miskulin M. Chonchol Overweight and obesity are predictors of progression in early autosomal dominant polycystic kidney disease J Am Soc Nephrol 2018 29 571 578 1:CAS:528:DC%2BC1MXhtlKis74%3D 10.1681/ASN.2017070819 29118087
M. Kanbay A.B. Yildiz F. Yavuz A. Covic A. Ortiz D. Siriopol The role of body mass index on IgA nephropathy prognosis: a systematic review and meta-analysis Int Urol Nephrol 2022 54 2567 2579 1:CAS:528:DC%2BB38Xht1SitrjJ 10.1007/s11255-022-03160-1 35278147
C. Garofalo S. Borrelli R. Minutolo P. Chiodini L. De Nicola G. Conte A systematic review and meta-analysis suggests obesity predicts onset of chronic kidney disease in the general population Kidney Int 2017 91 1224 1235 10.1016/j.kint.2016.12.013 28187985
V.D. D’Agati A. Chagnac A.P. de Vries M. Levi E. Porrini M. Herman-Edelstein M. Praga Obesity-related glomerulopathy: clinical and pathologic characteristics and pathogenesis Nat Rev Nephrol 2016 12 453 471 10.1038/nrneph.2016.75 27263398
J.I. Martínez-Montoro E. Morales I. Cornejo-Pareja F.J. Tinahones J.C. Fernández-García Obesity-related glomerulopathy: current approaches and future perspectives Obes Rev 2022 23 e13450 10.1111/obr.13450 35362662 9286698
M. Cortinovis N. Perico P. Ruggenenti A. Remuzzi G. Remuzzi Glomerular hyperfiltration Nat Rev Nephrol 2022 18 435 451 10.1038/s41581-022-00559-y 35365815
H.A. Chakkera A. Denic W.K. Kremers M.D. Stegall J.J. Larson H. Ravipati S.J. Taler J.C. Lieske L.O. Lerman J.J. Augustine A.D. Rule Comparison of high glomerular filtration rate thresholds for identifying hyperfiltration Nephrol Dial Transplant 2020 35 1017 1026 1:CAS:528:DC%2BB3cXht1Kqtr7O 10.1093/ndt/gfy332 30403810
E. den Bakker R. Gemke A. Bokenkamp Endogenous markers for kidney function in children: a review Crit Rev Clin Lab Sci 2018 55 163 183 10.1080/10408363.2018.1427041
H. Pottel N. Vrydags B. Mahieu E. Vandewynckele K. Croes F. Martens Establishing age/sex related serum creatinine reference intervals from hospital laboratory data based on different statistical methods Clin Chim Acta 2008 396 49 55 1:CAS:528:DC%2BD1cXhtVKmsr%2FF 10.1016/j.cca.2008.06.017 18621041
M. van Dam H. Pottel A.C.E. Vreugdenhil Creatinine-based GFR-estimating equations in children with overweight and obesity Pediatr Nephrol 2022 37 2393 2403 10.1007/s00467-021-05396-y 35211793 9395456
M. van Dam H. Pottel A.C.E. Vreugdenhil Relation between obesity-related comorbidities and kidney function estimation in children Pediatr Nephrol 2023 38 1867 1876 10.1007/s00467-022-05810-z 36416955
K. Karnebeek S. Thapar M. Willeboordse O.C.P. van Schayck A.C.E. Vreugdenhil Comorbidities in primary versus secondary school children with obesity and responsiveness to lifestyle intervention J Clin Endocrinol Metab 2019 104 3803 3811 10.1210/jc.2018-02318 30776292
T.J. Cole T. Lobstein Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity Pediatr Obes 2012 7 284 294 1:STN:280:DC%2BC38jjt1ymsA%3D%3D 10.1111/j.2047-6310.2012.00064.x 22715120
T. Reinehr N. Lass C. Toschke J. Rothermel S. Lanzinger R.W. Holl Which amount of BMI-SDS reduction is necessary to improve cardiovascular risk factors in overweight children? J Clin Endocrinol Metab 2016 101 3171 3179 1:CAS:528:DC%2BC28XhvVSksr%2FL 10.1210/jc.2016-1885 27285295
G.B. Haycock G.J. Schwartz D.H. Wisotsky Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults J Pediatr 1978 93 62 66 1:STN:280:DyaE1c7ntlentg%3D%3D 10.1016/S0022-3476(78)80601-5 650346
L. Hoste L. Dubourg L. Selistre V.C. De Souza B. Ranchin A. Hadj-Aïssa P. Cochat F. Martens H. Pottel A new equation to estimate the glomerular filtration rate in children, adolescents and young adults Nephrol Dial Transplant 2014 29 1082 1091 1:CAS:528:DC%2BC2cXnsVehsbk%3D 10.1093/ndt/gft277 24046193
H. Pottel L. Hoste F. Martens A simple height-independent equation for estimating glomerular filtration rate in children Pediatr Nephrol 2012 27 973 979 10.1007/s00467-011-2081-9 22252520
H. Pottel L. Hoste P. Delanaye Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m(2) Pediatr Nephrol 2015 30 821 828 10.1007/s00467-014-3002-5 25403744
H. Pottel J. Björk M. Courbebaisse L. Couzi N. Ebert B.O. Eriksen R.N. Dalton L. Dubourg F. Gaillard C. Garrouste A. Grubb L. Jacquemont M. Hansson N. Kamar E.J. Lamb C. Legendre K. Littmann C. Mariat T. Melsom L. Rostaing A.D. Rule E. Schaeffner P.O. Sundin S. Turner A. Bökenkamp U. Berg K. Åsling-Monemi L. Selistre A. Åkesson A. Larsson U. Nyman P. Delanaye Development and validation of a modified full age spectrum creatinine-based equation to estimate glomerular filtration rate: a cross-sectional analysis of pooled data Ann Intern Med 2021 174 183 191 10.7326/M20-4366 33166224
G.J. Schwartz A. Munoz M.F. Schneider R.H. Mak F. Kaskel B.A. Warady S.L. Furth New equations to estimate GFR in children with CKD J Am Soc Nephrol 2009 20 629 637 10.1681/ASN.2008030287 19158356 2653687
V.C. De Souza M. Rabilloud P. Cochat L. Selistre A. Hadj-Aissa B. Kassai B. Ranchin U. Berg M. Herthelius L. Dubourg Schwartz formula: is one k-coefficient adequate for all children? PLoS One 2012 7 e53439 10.1371/journal.pone.0053439 23285295 3532344
C.B. Pierce A. Muñoz D.K. Ng B.A. Warady S.L. Furth G.J. Schwartz Age- and sex-dependent clinical equations to estimate glomerular filtration rates in children and young adults with chronic kidney disease Kidney Int 2021 99 948 956 1:CAS:528:DC%2BB3MXmtFSqs7k%3D 10.1016/j.kint.2020.10.047 33301749
J. Björk U. Nyman P. Delanaye A. Grubb A. Larsson L. Vranken A. Åkesson H. Pottel A novel method for creatinine adjustment makes the revised Lund-Malmö GFR estimating equation applicable in children Scand J Clin Lab Invest 2020 80 456 463 10.1080/00365513.2020.1774641 32628043
J. Björk U. Nyman A. Larsson P. Delanaye H. Pottel Estimation of the glomerular filtration rate in children and young adults by means of the CKD-EPI equation with age-adjusted creatinine values Kidney Int 2021 99 940 947 10.1016/j.kint.2020.10.017 33157151
A. Chagnac T. Weinstein M. Herman J. Hirsh U. Gafter Y. Ori The effects of weight loss on renal function in patients with severe obesity J Am Soc Nephrol 2003 14 1480 1486 10.1097/01.ASN.0000068462.38661.89 12761248
M. van Dam J. Rijks E. Dorenbos F. Horuz K. van Dael A. Vreugdenhil The effect of one year lifestyle intervention on eGFR in children and adolescents with overweight, obesity and morbid obesity Sci Rep 2019 9 4504 10.1038/s41598-019-40767-4 30872684 6418201
