Low birth weight may increase CKD risk by 70%, highlighting importance of birth history
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Although previous studies have indicated that intrauterine growth restriction increases risk for future kidney failure, an analysis conducted in Norway shows the condition is strongly associated with chronic kidney disease.
More specifically, within the first 50 years of life, individuals with intrauterine growth restriction had a 60% to 70% higher risk for CKD diagnosis, according to the study, published in Clinical Journal of the American Society of Nephrology.
“Recent studies have emphasized the interplay between markers of intrauterine growth such as LBW [low birth weight], small for gestational age (SGA), and prematurity and risk [for] kidney disease in adult life,” Anna Gjerde, MD, of the department of medicine at Haugesund Hospital, and colleagues wrote. “An important paper from the Low Birth Weight and Nephron Number Working Group argued that individuals with LBW should undergo screening and follow-up to detect kidney disease or risk factors for kidney disease at an early age.”
In order to begin treatment earlier, slow disease progression and reduce treatment costs, the researchers contended that it is crucial to further examine the association between different markers of intrauterine growth restriction and risk for clinical kidney disease before the development of kidney failure.
Using data from the Medical Birth Registry of Norway and Norwegian Patient Registry, Gjerde and colleagues assessed the risk for various forms of kidney disease among 2,663,010 individuals born between 1967 and 2015. Exposures included LBW (below the 10th percentile), SGA (birth weight below the 10th percentile for gestational age) and preterm birth (< 37 weeks).
After mean follow-up of 26 years, the researchers found that 4,495 individuals had been diagnosed with CKD, whereas 12,818 had been diagnosed with other groups of kidney disease. LBW was associated with an OR for CKD of 1.72, SGA with an OR of 1.79 and preterm birth with an OR of 1.48. The researchers noted that results were similar between men and women, in contrast to other study findings.
The association between LBW and other forms of kidney disease was less pronounced, with adjusted ORs of 1.44 for acute kidney disease, 1.24 for glomerulonephritis, 1.35 for cystic kidney disease, and 1.15 for kidney disease resulting from malformations in the kidney or urinary tract.
“The main finding in our study is that it provides evidence that individuals born with LBW and SGA not only have higher risk for development of kidney failure, but also for the much more prevalent CKD,” Gjerde and colleagues wrote, adding that more studies are needed to address whether screening of individuals with intrauterine growth restriction could have a beneficial cost-benefit ratio and how intrauterine growth restriction may interact with other known kidney disease exposures.
“Starting now, we suggest that clinicians should ask their kidney patients for information on birth history,” they wrote.
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