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Increasing Obesity Prevalence in the United States Pediatric End-Stage Renal Disease Population

B. Shelton,1 P. MacLennan,1 R. Reed,1 M. Mustian,1 D. McWilliams,1 D. Sawinski,2 J. Locke.1

1Surgery, University of Alabama at Birmingham, Birmingham, AL
2Medicine, University of Pennsylvania, Philadelphia, PA.

Meeting: 2018 American Transplant Congress

Abstract number: B252

Keywords: Kidney, Obesity, Pediatric

Session Information

Session Name: Poster Session B: Kidney: Pediatrics

Session Type: Poster Session

Date: Sunday, June 3, 2018

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Background: Obesity prevalence among children in the United States (US) is high, but the rate of increase has slowed over time. Among pediatric end-stage renal disease (ESRD) patients, poor appetite and delayed growth are common. It is unknown if the pediatric ESRD population mirrors the obesity epidemic observed in the US pediatric population.

Methods: Incident pediatric ESRD patients with complete body mass index (BMI, kg/m2) data were identified from the United States Renal Data System (01/01/1999-12/31/2012, n=9,046). Weighted data from the National Health and Nutrition Examination Survey represented the US pediatric population. All BMI values were age and sex-standardized to BMI z scores using CDC standards for US children and were used to define obesity. Trends in BMI and obesity were examined by year of dialysis initiation. Trends in BMI slope were compared between the ESRD and US pediatric populations using linear regression.

Results: Mean BMI of pediatric ESRD patients from 1999-2000 was 21.2, compared to 21.9 in 2011-2012, a 3.3% increase. The US population mean BMI increased from 19.3 in 1999-2000 to 19.8, a 2.6% increase. A similar but more pronounced increase was noted in the prevalence of obesity (Table). A statistically significant increase in mean BMI over time (β: 0.07, 95% CI: 0.01, 0.12, p=0.03) and among ESRD patients independently was observed (β: 1.66, 95% CI: 1.34, 1.99, p<0.001); however, there was no significant interaction between year and patient population, suggesting rate of BMI increase for ESRD patients does not differ significantly from the total US population (β: 0.05, 95% CI: -0.03, 0.12, p=0.22).

Conclusion: BMI and prevalence of obesity among pediatric ESRD patients are increasing consistently with the US population. Given the increased dialysis-survival and decreased likelihood of transplantation associated with obesity in the adult population, future research should examine mortality on dialysis, transplantation rates, and medical expenditures among obese pediatric ESRD patients.

CITATION INFORMATION: Shelton B., MacLennan P., Reed R., Mustian M., McWilliams D., Sawinski D., Locke J. Increasing Obesity Prevalence in the United States Pediatric End-Stage Renal Disease Population Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Shelton B, MacLennan P, Reed R, Mustian M, McWilliams D, Sawinski D, Locke J. Increasing Obesity Prevalence in the United States Pediatric End-Stage Renal Disease Population [abstract]. https://atcmeetingabstracts.com/abstract/increasing-obesity-prevalence-in-the-united-states-pediatric-end-stage-renal-disease-population/. Accessed May 12, 2025.

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