Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity.
| Autor: | Marzuillo, Pierluigi, Carreras-Badosa, Gemma, Martínez-Calcerrada, José-María, Guarino, Stefano, Palma, Pier Luigi, Petrone, Delfina, Miraglia del Giudice, Emanuele, Bassols, Judit, López-Bermejo, Abel |
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| Předmět: |
KIDNEY disease diagnosis
KIDNEY abnormalities GLOMERULAR filtration rate BLOOD pressure HYPERTENSION STATURE REFERENCE values KIDNEYS CHILDHOOD obesity AGE distribution CROSS-sectional method BODY surface area PRIMARY health care RADIATION doses RESEARCH funding DESCRIPTIVE statistics DIAGNOSTIC errors LOGISTIC regression analysis CREATININE |
| Zdroj: | Pediatric Nephrology; May2023, Vol. 38 Issue 5, p1523-1532, 10p, 3 Charts, 3 Graphs |
| Abstrakt: | Background: We evaluated the diagnostic performance of height-, age- and body surface area (BSA)-based kidney length (KL) percentiles in the identification of at least one small kidney (KL < 3rd) and in the prediction of reduced estimated glomerular filtration rate (eGFR) and/or elevated blood pressure (BP) in children with and without overweight (OW)/obesity(OB). Methods: In this cross-sectional study, 744 apparently healthy children (mean age 8.3 years) were recruited in a primary care setting. Clinical data were collected, and serum creatinine and KL were measured. Height-, age- and BSA-based percentiles of KL were calculated and the association of at least one small kidney per subject with reduced eGFR and/or elevated BP was explored by logistic regression. Results: Two hundred fifty-seven out of seven hundred forty-four (34.5%) subjects were OW/OB and 127 (17.1%) had reduced eGFR or elevated BP. In separate analyses in children with OW/OB, the KL percentiles calculated on the basis of BSA were lower compared with height- and age-based KL percentiles. Consequently, the prevalence of a small kidney was significantly higher when evaluating percentiles of KL based on BSA compared with other percentiles. In logistic regression analysis, a small kidney was significantly associated with reduced eGFR and/or elevated BP only when using height-based KL percentiles. The KL percentiles according to BSA for the ideal weight (iBSA) showed similar performance compared with height-based percentiles. No differences in the diagnostic performance of different percentiles were found in children with normal weight. Conclusions: BSA-based percentiles underestimate KL in children with OW/OB. In these subjects, the use of height-based or iBSA-based percentiles should be preferred. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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