Risk Factors for Pediatric CKD Progression Identified

FRIDAY, Feb. 3, 2023 (HealthDay News) -- Chronic kidney disease (CKD) progression in children is associated with specific clinical risk factors, according to a study published online Jan. 24 in Journal of the American Society for Nephrology.

Caroline A. Gluck, M.D., from Nemours Children's Health in Wilmington, Delaware, and colleagues identified children aged 18 months to 18 years between 2009 and 2022 in a large electronic health records system who met criteria for CKD to evaluate CKD progression and assess risk factors for kidney function decline. CKD progression was defined as a composite of estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m², ≥50 percent decline in eGFR, long-term dialysis, or kidney transplant.

A total of 11,240 children with CKD were identified among 7,148,875 (15.7 per 10,000). The researchers found that CKD progression was associated with lower eGFR category (adjusted hazard ratios, 1.44, 2.38, and 5.75 for eGFR 45 to 59, 30 to 44, and 15 to 29 versus 60 to 89 mL/min per 1.73 m² at cohort entrance), glomerular disease (adjusted hazard ratio, 2.01), malignancy (adjusted hazard ratio, 1.79), proteinuria, hypertension, and proteinuria and hypertension together (adjusted hazard ratios, 2.23, 1.49, and 3.98), number of complex chronic comorbidities (adjusted hazard ratio, 1.07 per additional comorbid body system), male sex (adjusted hazard ratio, 1.16), and younger age at cohort entry (adjusted hazard ratio, 0.95 per year older).

"Our findings confirm several previously established risk factors for CKD progression from prior observational studies (glomerular disease, proteinuria, and hypertension) and provide face validity to our novel approach for studying pediatric CKD," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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