PMID- 30976899 OWN - NLM STAT- MEDLINE DCOM- 20200706 LR - 20200706 IS - 1432-198X (Electronic) IS - 0931-041X (Linking) VI - 34 IP - 9 DP - 2019 Sep TI - Association of low birth weight and prematurity with clinical outcomes of childhood nephrotic syndrome: a prospective cohort study. PG - 1599-1605 LID - 10.1007/s00467-019-04255-1 [doi] AB - BACKGROUND: Low birth weight (LBW)/prematurity have been proposed as risk factors for the development of kidney disease in adulthood. Whether there is an association between LBW/prematurity and poor renal outcomes in childhood onset nephrotic syndrome remains unknown. METHODS: Children with nephrotic syndrome diagnosed between 1 and 18 years of age were followed prospectively from 1996 to 2016 at The Hospital for Sick Children (N = 377). LBW/prematurity was defined as birth weight < 2500 g or gestational age < 36 weeks. Normal birth weight (NBW) was defined as birth weight >/= 2500 g. Measures evaluating clinical course of nephrotic syndrome include initial steroid-resistant nephrotic syndrome (SRNS), time to first relapse, and frequently relapsing nephrotic syndrome. Kaplan-Meier survival analysis, logistic regression, and Cox proportional hazards regression were used to determine the association of LBW/prematurity with clinical outcomes. RESULTS: Median birth weights in LBW/premature (n = 46) and NBW (n = 331) children were 2098 g (interquartile range [IQR] 1700-2325 g) and 3317 g (IQR 2977-3685 g), respectively. Odds of having SRNS were 3.78 (95% confidence interval [CI] 1.28-11.21) times higher among LBW/premature children than NBW children. An 8% decrease in odds of developing SRNS was observed for every 100 g increase in birth weight (adjusted odds ratio [OR] 0.92; 95% CI 0.86-0.98). Median time to first relapse did not differ (hazard ratio [HR] 0.89; 95% CI 0.53-1.16). CONCLUSIONS: LBW/premature children were more likely to develop SRNS but did not have a difference in time to first relapse with NBW children. Understanding the impact and mechanism of birth weight and steroid-resistant disease needs further study. FAU - Konstantelos, Natalia AU - Konstantelos N AD - Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada. AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. FAU - Banh, Tonny AU - Banh T AD - Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada. FAU - Patel, Viral AU - Patel V AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. FAU - Vasilevska-Ristovska, Jovanka AU - Vasilevska-Ristovska J AD - Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada. FAU - Borges, Karlota AU - Borges K AD - Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada. FAU - Hussain-Shamsy, Neesha AU - Hussain-Shamsy N AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. FAU - Noone, Damien AU - Noone D AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. FAU - Hebert, Diane AU - Hebert D AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. FAU - Radhakrishnan, Seetha AU - Radhakrishnan S AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. FAU - Licht, Christoph P B AU - Licht CPB AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. FAU - Langlois, Valerie AU - Langlois V AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. FAU - Pearl, Rachel J AU - Pearl RJ AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. AD - Department of Pediatrics, William Osler Health System, 101 Humber College Blvd, Etobicoke, ON, M9V 1R8, Canada. FAU - Parekh, Rulan S AU - Parekh RS AD - Child Health Evaluative Sciences, Research Institute, Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada. rulan.parekh@sickkids.ca. AD - University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada. rulan.parekh@sickkids.ca. AD - Division of Nephrology, Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. rulan.parekh@sickkids.ca. AD - University Health Network, 101 College St, Toronto, ON, M5G 1L7, Canada. rulan.parekh@sickkids.ca. AD - Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada. rulan.parekh@sickkids.ca. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190411 PL - Germany TA - Pediatr Nephrol JT - Pediatric nephrology (Berlin, Germany) JID - 8708728 RN - 0 (Glucocorticoids) SB - IM MH - Adolescent MH - Age of Onset MH - Birth Weight/physiology MH - Child MH - Child, Preschool MH - Drug Resistance/physiology MH - Female MH - Gestational Age MH - Glucocorticoids/*pharmacology/therapeutic use MH - Humans MH - Infant, Low Birth Weight/*physiology MH - Infant, Newborn MH - Infant, Premature/*physiology MH - Kidney/physiopathology MH - Male MH - Nephrotic Syndrome/drug therapy/*epidemiology/physiopathology MH - Prospective Studies MH - Recurrence MH - Risk Factors MH - Time Factors OTO - NOTNLM OT - Low birth weight OT - Nephrotic syndrome OT - Prematurity OT - Steroid resistant nephrotic syndrome OT - Time to first relapse EDAT- 2019/04/13 06:00 MHDA- 2020/07/07 06:00 CRDT- 2019/04/13 06:00 PHST- 2018/08/31 00:00 [received] PHST- 2019/03/29 00:00 [accepted] PHST- 2019/01/11 00:00 [revised] PHST- 2019/04/13 06:00 [pubmed] PHST- 2020/07/07 06:00 [medline] PHST- 2019/04/13 06:00 [entrez] AID - 10.1007/s00467-019-04255-1 [pii] AID - 10.1007/s00467-019-04255-1 [doi] PST - ppublish SO - Pediatr Nephrol. 2019 Sep;34(9):1599-1605. doi: 10.1007/s00467-019-04255-1. Epub 2019 Apr 11.