The work of a team of researchers at the University of Washington revealed a link between the development of chronic kidney disease (CKD) in children and certain maternal conditions experienced before or during pregnancy. The focus of the research was to explore possible links. Now that links have been found, additional study is needed to determine how or if changing these prenatal conditions might reduce the child's risk for CKD.
Dr. Christine Hsu of the university's Division of Nephrology in Seattle led the study of birth and medical records for children born in Washington between 1987 and 2008. The medical records of both the children and their mothers were included in the study. The study pool consisted of:
- 1,994 children diagnosed with CKD before age 21
- 20,032 children not diagnosed with CKD before age 21 (the control group)
The research revealed a prevalence for childhood CKD of 126.7 cases for every 100,000 births. The research team identified a link between the likelihood a child would develop kidney disease and certain maternal or pregnancy-related characteristics:
- High birth weight
- Maternal diabetes mellitus (type 2) diagnosed before conception
When either of these two factors were present in addition to certain other conditions, the child's risk of developing chronic kidney disease before age 21 was increased:
- Low birth weight
- Maternal gestational diabetes mellitus
- Maternal overweight
- Maternal obesity
When a woman who was a type 2 diabetic before conception gave birth to a child of low birth weight, the child was significantly more likely to develop renal dysplasia/aplasia. Renal dysplasia is a deformation of the kidney that occurs during fetal development. Aplasia is failure of the kidney to develop or function normally.
When a woman was type 2 diabetic before conception, was also overweight or obese, and gave birth to a child of low birth weight, the child was significantly more likely to suffer from obstructive uropathy. Obstructive uropathy is diagnosed when there is a functional or structural blockage of the flow of urine. Even if the blockage is partial, kidney failure can result if the blockage isn't corrected.
The study highlights the value of maintaining a healthy weight before conception and during pregnancy. Also beneficial is to strive to get type 2 diabetes into a state of healthy management before conception. Further research to assess whether making maternal modifications reduces the child's risk of developing chronic kidney disease before age 21 is anticipated.
Source: Hsu, Christine W, et al. "Prenatal Risk Factors for Childhood CKD." JASN. The American Society of Nephrology. Apr 17, 2014. Web. May 1, 2014.