Chinese Journal of Evidence -Based Pediatric ›› 2017, Vol. 12 ›› Issue (2): 93-99.

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The relationship between birth weight and chronic kidney disease:a systematic review and meta-analysis

ZHANG Ruo-lin, SHUAI Lan-jun,LI Xiao-yan, CHEN Hai-xia, WANG Ying, HE Qing-nan   

  1. Laboratory of Pediatric Nephrology,Institute of Pediatrics,Central South University, The Second Xiang-Ya Hospital, Changsha 410011, China
  • Received:2017-03-07 Revised:2017-04-25 Online:2017-04-25 Published:2017-04-25
  • Contact: HE Qing-nan, E-mail: heqn2629@163.com

Abstract:

objective: To systematically review the association between birth weight with risk of the chronic kidney disease. Methods: The Cochrane Library, MEDLINE, OVID, Springer, VIP, WangFang Data and CNKI up to June 30, 2016 were searched to retrieve the online observation studies about birth weight and chronic kidney disease and other relative outcomes. The articles were selected if they were published in English or Chinese regarding the association between birth weight and CKD, which included the exact information on OR and 95%CI. Excluded studies: Studies that assessed the final outcome among neonates or children less than 1 year old, the participants of studies who were infected in utero, congenital abnormalities, the mothers who were exposed to toxins, as well as the incompletely information literature. Two reviewers inspected the included studies on the association between birth weight and chronic kidney disease independently. Quality assessment was performed based on the Newcastle Ottawa Scale( case-control study and cohort study) and AHRQ(cross-sectional study). OR and 95%CI were extracted from the selected articles and then analyzed with Stata 12.0 software by the way of DerSimonian & Laird. Results: Ten observational studies containing four casecontrol studies(three articles in 8 points and one article in 7 points ), four cohort studies(three articles in 7 points and one article in 8 points ) and two crosssectional studies(7 points and 8 points for the two articles ) were selected finally. The overall combination of weighted estimates from the selected 10 studies about low birth weight associated with risk of the chronic kidney disease was 1.80 (1.37-2.35). The risks of albuminuria (OR, 2.58; 95% CI, 1.49-4.46), endstage renal disease (OR, 1.42; 95% CI, 1.22-1.66), or lower estimated glomerular filtration rate (OR, 1.87; 95% CI, 1.19-2.94) were similar with the chronic kidney disease. However,according to the subgroup analysis that the combined OR of high birth weight between endstage renal disease and lower estimated glomerular filtration rate was OR, 1.19; 95% CI, 0.94-1.49 and OR, 0.09; 95% CI, 0.93-1.27,which showed no significant impact. In the subgroup analysis by gender,increased risk was only found in men:1.83 (1.10-3.05),unexpectedly.Finally, the Egger regression method showed no publication bias.Conclusion: Only men with low birth weight had a greater CKD risk in later life. And the high birth weight did not show any significant impact on CKD.

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