Filler Guido, Reimão Sílvia Mansur, Kathiravelu Anusha, Grimmer Joanne, Feber Janusz, Drukker Alfred
Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario (CHEO), University of Ottawa, Ottawa, ON, Canada.
Int Urol Nephrol. 2007;39(4):1235-40. doi: 10.1007/s11255-007-9258-y. Epub 2007 Sep 20.
Obesity is an independent risk factor for chronic kidney disease (CKD). We compared the body composition of pediatric nephrology patients with that of the general child population over 2 decades.
About 4,959 patients above 2 years of age (mean: 9.6 +/- 4.5) were referred to a tertiary pediatric nephrology clinic from 1985 to 2006. In 3,422 patients (69.0% with the same mean age) there were sufficient data to analyze body composition, expressed as body mass index (BMI) Z-score and calculated on the basis of normal data taken from the National (USA) Center for Health Statistics (2000).
Hematuria (21.68%), recurrent urinary tract infections (16.09%), proteinuria (13.95%) and hypertension (8.27%) were the most common referral diagnoses. Mean BMI Z-score of the pediatric nephrology patients increased significantly from 0.29 +/- 1.07 during the years 1985-1991 to 0.44 +/- 1.27 in 1992-1999 and 0.87 +/- 1.70 in 2000-2006 (P < 0.0001, ANOVA). Whereas the rate of the increase in BMI Z-score was not statistically different from that seen in the normal population, the young nephrology patients had over the entire time consistently significantly higher BMI Z-scores (average +0.72) than the comparable normal USA data. Several disease groups with potential for development of CKD had higher BMI Z-scores than found in the age- and sex-adjusted control data.
The increased rate of obesity in our studied population suggests that pediatric nephrology patients are at even greater risk for developing CKD later in life than could be predicted from their renal disease only. We recommend therapeutic intervention to address this potentially modifiable risk factor.
肥胖是慢性肾脏病（CKD）的一个独立危险因素。我们比较了20多年来儿科肾脏病患者与普通儿童人群的身体组成。
1985年至2006年期间，约4959名2岁以上（平均年龄：9.6±4.5岁）的患者被转诊至一家三级儿科肾脏病诊所。在3422名患者（平均年龄相同，占69.0%）中，有足够的数据来分析身体组成，以体重指数（BMI）Z评分表示，并根据从美国国家卫生统计中心（2000年）获取的正常数据进行计算。
血尿（21.68%）、复发性尿路感染（16.09%）、蛋白尿（13.95%）和高血压（8.27%）是最常见的转诊诊断。儿科肾脏病患者的平均BMI Z评分从1985 - 1991年的0.29±1.07显著增加到1992 - 1999年的0.44±1.27，以及2000 - 2006年的0.87±1.70（方差分析，P < 0.0001）。虽然BMI Z评分的增加率与正常人群相比无统计学差异，但年轻的肾脏病患者在整个时间段内的BMI Z评分始终显著高于美国可比的正常数据（平均高0.72）。几个有发展为CKD潜力的疾病组的BMI Z评分高于年龄和性别调整后的对照数据。
我们研究人群中肥胖率的增加表明，儿科肾脏病患者在生命后期发生CKD的风险比仅根据其肾脏疾病所预测的风险更大。我们建议进行治疗干预以应对这一潜在的可改变的风险因素。
