title: Early-life overweight trajectory and CKD in the 1946 British birth cohort study.
abstract: BACKGROUND
  Few studies have examined the impact of childhood obesity on later kidney disease, and consequently, our understanding is very limited.
  
  
  METHODS
  Longitudinal population-based cohort.
  
  
  METHODS
  The Medical Research Council National Survey of Health and Development, a socially stratified sample of 5,362 singletons born in 1 week in March 1946 in England, Scotland, and Wales, of which 4,340 were analyzed.
  
  
  METHODS
  Early-life overweight latent classes (never, prepubertal only, pubertal onset, or always), derived from repeated measurements of body mass index between ages 2 and 20 years.
  
  
  METHODS
  The primary outcome was chronic kidney disease (CKD), defined as creatinine- or cystatin C-based estimated glomerular filtration rate (eGFRcr and eGFRcys, respectively) <60 mL/min/1.73 m² or urine albumin-creatinine ratio (UACR) ≥3.5 mg/mmol measured at age 60-64 years. Associations were explored through regression analysis, with adjustment for socioeconomic position, smoking, physical activity level, diabetes, hypertension, and overweight at ages 36 and 53 years.
  
  
  RESULTS
  2.3% of study participants had eGFRcr <60 mL/min/1.73 m², 1.7% had eGFRcys <60 mL/min/1.73 m², and 2.9% had UACR ≥3.5 mg/mmol. Relative to being in the never-overweight latent class, being in the pubertal-onset- or always-overweight latent classes was associated with eGFRcys-defined CKD (OR, 2.04; 95% CI, 1.09-3.82). Associations with CKD defined by eGFRcr (OR, 1.27; 95% CI, 0.71-2.29) and UACR (OR, 1.33; 95% CI, 0.70-2.54) were less marked, but in the same direction. Adjustment for lifestyle and health factors had little impact on effect estimates.
  
  
  CONCLUSIONS
  A low prevalence of CKD resulted in low statistical power. No documentation of chronicity for outcomes. All-white study population restricts generalizability.
  
  
  CONCLUSIONS
  Being overweight in early life was found to be associated with eGFRcys-defined CKD in later life. The associations with CKD defined by eGFRcr and UACR were less marked, but in the same direction. Reducing or preventing overweight in the early years of life may significantly reduce the burden of CKD in the population.
authors.affiliation: Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom. richard.silverwood@lshtm.ac.uk
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Silverwood
authors.forename: Mary
authors.initials: M
authors.lastname: Pierce
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.forename: Claudia
authors.initials: C
authors.lastname: Thomas
authors.forename: Charles
authors.initials: C
authors.lastname: Ferro
authors.forename: Caroline
authors.initials: C
authors.lastname: Savage
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.forename: Dorothea
authors.initials: D
authors.lastname: Nitsch
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D050177:Overweight / Q000453:epidemiology*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Childhood obesity; chronic kidney disease; estimated glomerular filtration rate