The evaluation of kidney function estimation during lifestyle intervention in children with overweight and obesity.

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Title: The evaluation of kidney function estimation during lifestyle intervention in children with overweight and obesity.
Authors: van Dam, Mark J C M, Pottel, Hans, Delanaye, Pierre, Vreugdenhil, Anita C E
Source: Pediatric Nephrology, 39 (11), 3271 - 3278 (2024-11)
Publisher Information: Springer Science and Business Media Deutschland GmbH, 2024.
Publication Year: 2024
Subject Terms: 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, Human health sciences, Urology & nephrology, Sciences de la santé humaine, Urologie & néphrologie
Description: [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.
Document Type: journal article
http://purl.org/coar/resource_type/c_6501
article
peer reviewed
Language: English
Relation: https://link.springer.com/content/pdf/10.1007/s00467-024-06435-0.pdf; urn:issn:0931-041X; urn:issn:1432-198X
DOI: 10.1007/s00467-024-06435-0
Access URL: https://orbi.uliege.be/handle/2268/322337
Rights: open access
http://purl.org/coar/access_right/c_abf2
info:eu-repo/semantics/openAccess
Accession Number: edsorb.322337
Database: ORBi
Description
Abstract:[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.
DOI:10.1007/s00467-024-06435-0