Association between low birth weight and childhood-onset chronic kidney disease in Japan: a combined analysis of a nationwide survey for paediatric chronic kidney disease and the National Vital Statistics Report

Hirano, Daishi; Ishikura, Kenji; Uemura, Osamu; Ito, Shuichi; Wada, Naohiro; Hattori, Motoshi; Ohashi, Yasuo; Hamasaki, Yuko; Tanaka, Ryojiro; Nakanishi, Koichi; Kaneko, Tetsuji; Honda, Masashi

doi:10.1093/ndt/gfv425

Cited by 51 publications

(36 citation statements)

References 18 publications

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“…18,20,23 These associations are stronger in children and adolescents but continue up to an advanced age. 20,24,25 The link between developmental circumstances and risk of CKD appears, at least in part, to be mediated by altered renal development in utero or shortly after birth, which is associated with a reduced nephron number, subsequent hyperfiltration, and predisposition to hypertension. 26 Globally, approximately 10% of babies are born preterm, a proportion that is similar across income regions, 27 with the risk factors in developed countries including preeclampsia, prior preterm birth, advanced maternal age, chronic maternal illness, assisted reproduction, and multiple gestations.…”

Section: Primordial Prevention Of Ckdmentioning

confidence: 99%

Preventing CKD in Developed Countries

Luyckx

Cherney

Bello

2020

Kidney International Reports

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Chronic kidney disease (CKD) is an important public health concern in developed countries because of both the number of people affected and the high cost of care when prevention strategies are not effectively implemented. Prevention should start at the governance level with the institution of multisectoral polices supporting sustainable development goals and ensuring safe and healthy environments. Primordial prevention of CKD can be achieved through implementation of measures to ensure healthy fetal (kidney) development. Public health strategies to prevent diabetes, hypertension, and obesity as risk factors for CKD are important. These approaches are cost-effective and reduce the overall noncommunicable disease burden. Strategies to prevent nontraditional CKD risk factors, including nephrotoxin exposure, kidney stones, infections, environmental exposures, and acute kidney injury (AKI), need to be tailored to local needs and epidemiology. Early diagnosis and treatment of CKD risk factors such as diabetes, obesity, and hypertension are key for primary prevention of CKD. CKD tends to occur more frequently and to progress more rapidly among indigenous, minority, and socioeconomically disadvantaged populations. Special attention is required to meet the CKD prevention needs of these populations. Effective secondary prevention of CKD relies on screening of individuals at risk to detect and treat CKD early, using established and emerging strategies. Within high-income countries, barriers to accessing effective CKD therapies must be recognized, and public health strategies must be developed to overcome these obstacles, including training and support at the primary care level to identify individuals at risk of CKD, and appropriately implement clinical practice guidelines.

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Section: Primordial Prevention Of Ckdmentioning

confidence: 99%

Preventing CKD in Developed Countries

Luyckx

Cherney

Bello

2020

Kidney International Reports

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“…Maternal gestational diabetes and overweight or obesity were also significantly associated with childhood CKD (Hsu et al, 2014). In a Japanese study, 20% of childhood CKD was attributable to LBW or preterm birth (Hirano et al, 2016). Consistent with these observations, meta-analysis of 18 studies (including over 2 million individuals) reported a 70% increased risk of CKD (defined as albuminuria, reduced GFR or ESKD; OR 1.73, 95% CI 1.44-2.08) with LBW (White et al, 2009).…”

Section: Chronic Kidney Disease and End-stage Kidney Diseasementioning

confidence: 71%

“…Such individuals may have significant enough nephron deficits to initiate the cycle of progressive nephron loss. Among children attending pediatric renal clinics, strong associations between LBW and preterm birth and childhood CKD (including obstructive uropathy and aplasia/dysplasia) have been reported compared with the general pediatric population (Hsu et al, 2014;Hirano et al, 2016). Maternal gestational diabetes and overweight or obesity were also significantly associated with childhood CKD (Hsu et al, 2014).…”

Section: Chronic Kidney Disease and End-stage Kidney Diseasementioning

confidence: 99%

Clinical consequences of developmental programming of low nephron number

Luyckx

Brenner

2019

The Anatomical Record

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Nephron number in humans varies up to 13‐fold, likely reflecting the impact of multiple factors on kidney development, including inherited body size and ethnicity, as well as maternal health and nutrition, fetal exposure to gestational diabetes or preeclampsia and other environmental factors, which may potentially be modifiable. Such conditions predispose to low or high offspring birth weight, growth restriction or preterm birth, which have all been associated with increased risks of higher blood pressures and/or kidney dysfunction in later life. Low birth weight, preterm birth, and intrauterine growth restriction are associated with reduced nephron numbers. Humans with hypertension and chronic kidney disease tend to have fewer nephrons than their counterparts with normal blood pressures or kidney function. A developmentally programmed reduction in nephron number therefore enhances an individual's susceptibility to hypertension and kidney disease in later life. A low nephron number at birth may not lead to kidney dysfunction alone except when severe, but in the face of superimposed acute or chronic kidney injury, a kidney endowed with fewer nephrons may be less able to adapt, and overt kidney disease may develop. Given that millions of babies are born either too small, too big or too soon each year, the population impact of altered renal programming is likely to be significant. Many gestational exposures are modifiable, therefore urgent attention is required to implement public health measures to optimize maternal, fetal, and child health, to prevent or mitigate the consequences of developmental programming, to improve the health future generations.

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“…Hirano and colleagues demonstrated a strong association between birth weight and gestational age with childhood-onset CKD (36). In babies born at term, the majority of nephron formation occurs during the last trimester of gestation with nephrogenesis completed by week 36 of gestation (37).…”

Section: Epidemiological Studies Linking Birth Weight and Renal DImentioning

confidence: 99%

Complications during pregnancy and fetal development: implications for the occurrence of chronic kidney disease

Newsome

Davis

Ojeda

et al. 2017

Expert Review of Cardiovascular Therapy

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Introduction Numerous epidemiological studies indicate an inverse association between birth weight and the risk for chronic kidney disease. Areas covered Historically, the first studies to address the developmental origins of chronic disease focused on the inverse relationship between birth weight and blood pressure. A reduction in nephron number was a consistent finding in low birth weight individuals and experimental models of developmental insult. Recent studies indicate that a congenital reduction in renal reserve in conjunction with an increase in blood pressure that has its origins in fetal life increases vulnerability to renal injury and disease. Expert commentary Limited experimental studies have investigated the mechanisms that contribute to the developmental origins of kidney disease. Several studies suggest that enhanced susceptibility to renal injury following a developmental insult is altered by sex and age. More in-depth studies are needed to clarify how low birth weight contributes to enhanced renal risk, and how sex and age influence this adverse relationship.

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Association between low birth weight and childhood-onset chronic kidney disease in Japan: a combined analysis of a nationwide survey for paediatric chronic kidney disease and the National Vital Statistics Report

Abstract: Both birth weight and gestational age were strongly associated with childhood-onset CKD in this study.

Cited by 51 publications

References 18 publications

Preventing CKD in Developed Countries

Preventing CKD in Developed Countries

Clinical consequences of developmental programming of low nephron number

Complications during pregnancy and fetal development: implications for the occurrence of chronic kidney disease

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