Risk Factors for the Progression of Chronic Kidney Disease in Children

Ahn, Yo Han; Kang, Hee Gyung; Ha, Il‐Soo

doi:10.3339/jkspn.2021.25.1.1

Cited by 2 publications

(1 citation statement)

References 42 publications

(44 reference statements)

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“…Children with CKD have different comorbidities than adults, seizure disorders, neurocognitive delays, and congenital heart disease, that confound their care and contribute to a heavy burden of care coordination [1]. In addition, children and adolescents with CKD face lifelong increases in morbidity and mortality and decreased quality of life [2]. However, because most information is adult-focused, there is a suboptimal understanding of pediatric CKD.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal progression trajectory of estimated glomerular filtration rate in children with chronic kidney disease: results from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease)

Yang,

Kim,

Park

et al. 2024

Kidney Res Clin Pract

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Background: The natural course of chronic kidney disease (CKD) progression in children varies according to their underlying conditions. This study aims to identify different patterns of subsequent decline in kidney function and investigate factors associated with different patterns of estimated glomerular filtration rate (eGFR) trajectories. Methods: We analyzed data from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease), which is a longitudinal, prospective cohort study. A latent class linear mixed model was applied to identify the trajectory groups.Results: In a total of 287 patients, the median baseline eGFR (mL/min/1.73 m 2 ) was 63.3, and the median age was 11.5 years. The eGFR decline rate was -1.54 during a 6.0-year follow-up. The eGFR trajectory over time was classified into four groups. Classes 1 (n = 103) and 2 (n = 11) had a slightly reduced eGFR at enrollment with a stable trend (ΔeGFR, -0.2/year) and a rapid decline eGFR over time (ΔeGFR, -10.5/year), respectively. Class 3 had a normal eGFR (n = 16), and class 4 had a moderately reduced eGFR (n = 157); both these chasses showed a linear decline in eGFR over time (ΔeGFR, -4.1 and -2.4/year). In comparison with classes 1 and 2, after adjusting for age, causes of primary renal disease, and baseline eGFR, nephrotic-range proteinuria was associated with a rapid decline in eGFR (odds ratio, 8.13). Conclusion:We identified four clinically relevant subgroups of kidney function trajectories in children with CKD. Most children showed a linear decline in eGFR; however, there are different patterns of eGFR trajectories.

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Section: Introductionmentioning

confidence: 99%

Longitudinal progression trajectory of estimated glomerular filtration rate in children with chronic kidney disease: results from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease)

Yang,

Kim,

Park

et al. 2024

Kidney Res Clin Pract

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Arterial hypertension as a risk factor for the development of CKD in children with CAKUT syndrome and its correction

Karimdzhanov,

Yusupova,

Iskanova

et al. 2024

Nefrologiâ (St.-Peterbg.)

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The review is devoted to the development of end-stage renal failure (ESRD) in children with congenital anomalies of the kidneys and urinary tract (CAKUT syndrome. In this regard, measures to slow the progression of chronic kidney disease (CKD) are important. One of the independent risk factors for a decrease in excretory renal function is arterial hypertension (AH), the correction of which is a mandatory component of nephroprotection. CAKUT syndrome is associated with a congenital decrease of the mass of active nephrons, which inevitably leads to hyperfiltration, the main cause of the development of ESRD has a high prevalence in CACUT syndrome and plays a special role in maintaining hyperfiltration. The presence of cysts, nephrosclerosis sites, and endothelial dysfunction contribute to the activation of renin secretion with a further increase in the role of the renin-angiotensin-aldosterone system (RAAS). Angiotensin II is not only a powerful vasoconstrictor. Its effects on sympathetic stimulation of dense spot, hyperplasia of smooth muscle cells, increased expression of several growth factors, cytokines and chemokines is known. The result of the interaction of this complex is the development of glomerular hypertrophy, tubulointerstitial inflammation and fibrosis. Blood pressure correction should begin with lifestyle modification. It is recommended to start taking antihypertensive drugs in children with blood pressure > 90 percentile. Among the first-line pharmacological drugs for the treatment of hypertension, angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin II type I receptor blockers (ARBs) play a major role. Unlike adults, a combination of them is possible.

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Risk Factors for the Progression of Chronic Kidney Disease in Children

Cited by 2 publications

References 42 publications

Longitudinal progression trajectory of estimated glomerular filtration rate in children with chronic kidney disease: results from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease)

Longitudinal progression trajectory of estimated glomerular filtration rate in children with chronic kidney disease: results from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease)

Arterial hypertension as a risk factor for the development of CKD in children with CAKUT syndrome and its correction

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