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Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity.


ABSTRACT:

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

SUBMITTER: Marzuillo P 

PROVIDER: S-EPMC10060296 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Publications

Body surface area-based kidney length percentiles misdiagnose small kidneys in children with overweight/obesity.

Marzuillo Pierluigi P   Carreras-Badosa Gemma G   Martínez-Calcerrada José-María JM   Guarino Stefano S   Palma Pier Luigi PL   Petrone Delfina D   Miraglia Del Giudice Emanuele E   Bassols Judit J   López-Bermejo Abel A  

Pediatric nephrology (Berlin, Germany) 20220902 5


<h4>Background</h4>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 < 3<sup>rd</sup>) 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).<h4>Methods</h4>In this cross-sectional study, 744 apparently healthy children (mean age 8.3 years) were recruited i  ...[more]

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