Low birth weight linked to chronic kidney disease: review of the evidence

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1. Low birth weight is identified as a risk factor for later life hypertension and chronic kidney disease (CKD).

2. Maternal health/nutrition, genetics, and prenatal/postnatal environment are risk factors for low birth weight.

Evidence Rating Level: 3 (Fair)

Study Rundown: Developmental programming is a theory that connects environmental effects during fetal and early childhood development to the onset of disease in later-life. In particular, much attention has been focused on connections between CKD and nutritional status during fetal and early childhood development. This article reviews research looking at developmental programming on nephrogenesis and kidney function as chronic kidney disease incidence has risen significantly since 1990.

Researchers have identified a direct correlation between birth weight and the development of nephrons in children. Decreased nephrons in the kidney have an effect on filtration surface area and can thus contribute to hypertension and chronic kidney disease. Risk factors for low birth weight include maternal health/nutrition, genetic predisposition, and prenatal/postnatal environment. However, researchers have also found that individuals born with low-birth weight who were subsequently overfed during childhood and adolescence to compensate were found to not develop greater kidney function. In contrast, many of these “catch-up” individuals were found to develop chronic diseases such as obesity, hypertension, and renal failure. Based on this review, researchers argue that risk factors for low birth weight should be used to identify individuals early on as ‘at risk’ for chronic kidney disease later in life and provide appropriate nutrition and monitoring.

Click to read the study, published today in The Lancet

Relevant Reading: Effects of prenatal exposure to the Dutch famine on adult disease in later life: an overview

In-Depth [review]: Early research in the field of developmental programming looked at the incidence of cardiovascular disease development in a birth cohort of individuals born during, or after, the1944 Dutch famine (Roseboom et al., 2001). Researchers have also found that independent of socioeconomics, mothers who themselves were low birth weight were more likely to give birth to babies of low birth weight (Collins et al., 2010). These findings indicate the possibility of intergenerational effects. Research in developmental programming integrates both genetic and environmental influences on disease and has been seen as a method for identifying risk at early stages for patients. Research in this field is continuing to occur looking at effects of pollution, toxicology, and epigenetics.

By Jordan Anderson and Andrew Bishara

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