Obese mothers more likely to have kids with CKD: study

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Obese mothers more likely to have kids with CKD: study

09:43, November 22, 2010      

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Mothers who are obese or have diabetes may be more likely to have children with chronic kidney disease (CKD), according to research findings released on Saturday.

Researchers at University of Washington, Seattle, presented the findings to the American Society of Nephrology's 43rd Annual Meeting and Scientific Exposition in Denver, Colorado.

The study included more than 4,000 patients with childhood CKD - - diagnosed at age 21 or younger -- in Washington State.

These patients were compared to more than 20,000 healthy children to evaluate possible relationships between a pregnant woman having diabetes, being obese or overweight, and the risk of her child developing CKD anytime during infancy, childhood, or adolescence.

The overall rate of childhood CKD was approximately 0.26 percent -- about one case per 400 live births. When investigators adjusted for length of gestation, CKD risk was 69 percent higher for children whose mothers had diabetes before pregnancy. For children whose mothers developed diabetes during pregnancy (gestational diabetes), there was a 28 percent increase in CKD risk. Children of obese mothers demonstrated a 22 percent increase in CKD risk.

When specific causes of kidney disease were analyzed, children whose mothers had diabetes before pregnancy had nearly a 700 percent increase in the risk of kidney-related birth defects (renal aplasia/dysplasia).

"Developmental abnormalities of the kidney and urinary tract are the most common cause of childhood CKD," said lead researcher Christine W. Hsu, MD.

The risk of urinary blockage (obstructive uropathy) -- which can lead to CKD -- was increased by 34 percent for children whose mothers had gestational diabetes, 23 percent in those whose mothers were obese, and 21 percent in those whose mothers were overweight but not obese.

In adults, CKD is often related to medical conditions like diabetes and high blood pressure. In contrast, "development of childhood CKD may be programmed prenatally," said Hsu.

"Our research shows that childhood CKD is modestly associated with maternal diabetes and maternal overweight or obesity, with the strongest association between abnormal kidney development and maternal diabetes," said Hsu. "Previous studies have demonstrated that maternal diabetes is associated with an increased risk of general congenital abnormalities. However, with strict control of maternal diabetes, the rate of congenital malformations is similar to that of non-diabetic mothers."

The new results raise the possibility that stricter control of diabetes and weight control during pregnancy could decrease children's risk of developing CKD. "However, this would have to be evaluated in future research," said Hsu.

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