Low birth weight and chronic kidney disease with progression to kidney failure in children.

BACKGROUND

It is unclear whether low birth weight (LBW), preterm birth and small for gestational age (SGA) could synergistically cause chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This cohort study was conducted to examine their individual and combined impacts on the development of CKD and ESKD in childhood.

METHODS

From the Taiwan Maternal and Child Health Database, we identified 1 477 128 newborns born between 1 January 2009 and 31 December 2016. We used a multivariable Cox regression model to assess the excess risk of CKD and ESKD in children with LBW/preterm/SGA. They were followed from birth until the occurrence of outcomes or until 31 December 2018, with an average follow-up of 5.78 years.

RESULTS

This study included 1 361 071 infants with birth weight ≥2500 g (92.14%), 104 855 infants with low birth weight (1500 g to <2500 g) (7.10%), 6843 infants with very low birth weight (1000 g to <1500 g) (0.46%) and 4349 infants with extremely low birth weight (<1000 g) (0.29%). The multivariable-adjusted model showed that male infants with low birth weight were associated with an increased risk of CKD [adjusted hazard ratio (aHR) 1.20, 95% confidence interval (CI) 1.08-1.32] and ESKD (aHR 1.64, 95% CI 1.37-1.97). Female infants with LBW had an increased risk of CKD (aHR 1.18, 95% CI 1.06-1.32) and ESKD (aHR 1.31, 95% CI 1.09-1.58) than those without LBW. In addition to LBW, infants with preterm or SGA condition also had a significantly and synergistically increased risk of CKD and ESKD compared with full-term infants.

CONCLUSION

We found children with LBW, preterm birth or SGA had a significantly increased risk of CKD and ESKD compared with children without intrauterine growth restriction.