Journal Article

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

Pottel, Hans, van Dam, Mark J. C. M., Vreugdenhil, Anita C. E., Delanaye, Pierre

2024

Overview

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 m 2 ) 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. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V,Springer Science and Business Media Deutschland GmbH
• Subject: Adolescent / Age / Age determination / Body height / Body Mass Index / Body weight / Care and treatment / Child / Childhood obesity / Children / Clinical trials / Creatinine / Creatinine - blood / eGFR / Female / Glomerular Filtration Rate / Health aspects / Human health sciences / Humans / Kidney - physiopathology / Kidney diseases / Kidney Function Tests - methods / Kidneys / Life Style / Lifestyle intervention / Lifestyles / Longitudinal Studies / Male / Medicine / Medicine & Public Health / Nephrology / Obesity / Original / Original Article / Overweight / Overweight - physiopathology / Overweight - therapy / Pediatric Obesity - blood / Pediatric Obesity - physiopathology / Pediatric Obesity - therapy / Pediatric research / Pediatrics / Pediatrics, Perinatology and Child Health / Physiological aspects / Renal Insufficiency, Chronic - blood / Renal Insufficiency, Chronic - physiopathology / Renal Insufficiency, Chronic - therapy / Sciences de la santé humaine / Standard scores / Urologie & néphrologie / Urology / Urology & nephrology