Association of Neck, Wrist and Hip Circumferences with Kidney Function in Children and Adolescents: The CASPIAN- V Study

Abstract

Aim: Some evidence exists concerning the relationship between anthropometric measurements and chronic kidney disease. This study aims to investigate the association of neck circumferences (NC), wrist circumferences (WC) and hip (HC) circumferences with kidney function in a pediatric population. Materials and Methods: In this national study, 4.200 students aged 7-18 years were selected by random cluster sampling from 30 provinces of Iran. NC, WC and HC were measured according to standard protocol and were categorized to either low or high according to their age-sex specific median values. The estimated glomerular filtration rate (eGFR) was calculated based on the "updated" Schwartz equation. Results: The response rate was 91.5 (n=3.843). The mean standard deviation of eGFR was 96.71 (19.46), 96.49 (21.69), and 96.59 (20.66) mL/minimum/1.73 m(2) for girls, boys and the total population, respectively. Compared to other participants, those in the high NC group had significantly higher eGFR (102.12 +/- 21.31 vs 90.65 +/- 18.18, p<0.001) and high creatinine (Cr) (0.66 +/- 0.14 vs 0.63 +/- 0.11 mg/dl, p<0.001). Individuals categorized as high WC had significantly higher eGFR (102.12 +/- 2131vs 90.83 +/- 18.16, p<0.001) and Cr (0.66 +/- 0.15 vs 0.63 +/- 0.10) mg/dL, p<0.001). In the multivariate model, high NC, WC and HC were associated with higher eGFR (p<0.001). Moreover, each one-unit (cm) increment in NC, WC and HC increased eGFR by 1.42, 3.24 and 0.46 units, respectively. Conclusion: The findings of this large population-based study suggest that simple anthropometric measurements, such as WC and NCs, can be used in epidemiological studies to determine those children and adolescents that might be at risk of kidney dysfunction.