Urological Disorders in Chronic Kidney Disease in Children Cohort: Clinical Characteristics and Estimation of Glomerular Filtration Rate
Published Date:Oct 2011
Source:J Urol. 2011; 186(4):1460-1466.
And Neonatal Diseases And Abnormalities
Glomerular Filtration Rate
Pubmed Central ID:PMC3718457
Funding:1K23DK078671/DK/NIDDK NIH HHS/United States
K23 DK078671/DK/NIDDK NIH HHS/United States
K24 DK078737/DK/NIDDK NIH HHS/United States
U01 DK066174/DK/NIDDK NIH HHS/United States
U01-CK-82194/CK/NCEZID CDC HHS/United States
U01-DK-66116/DK/NIDDK NIH HHS/United States
U01-DK-66143/DK/NIDDK NIH HHS/United States
U01-DK-66174/DK/NIDDK NIH HHS/United States
UL1 RR024989/RR/NCRR NIH HHS/United States
Urological disorders are the most common cause of pediatric chronic kidney disease. We determined the characteristics of children with urological disorders and assessed the agreement between the newly developed bedside glomerular filtration rate estimating formula with measured glomerular filtration rate in 586 patients in the Chronic Kidney Disease in Children study.
Materials and Methods
The Chronic Kidney Disease in Children study is a prospective, observational cohort of children recruited from 48 sites in the United States and Canada. Eligibility requirements include age 1 to 16 years and estimated glomerular filtration rate by original Schwartz formula 30 to 90 ml/min/1.73 m2. Baseline demographics, clinical variables and glomerular filtration rate were assessed. Bland-Altman analysis was conducted to assess agreement between estimated and measured glomerular filtration rates.
Of the 586 participants with at least 1 glomerular filtration rate measurement 348 (59%) had an underlying urological diagnosis (obstructive uropathy in 118, aplastic/hypoplastic/dysplastic kidneys in 104, reflux in 87 and other condition in 39). Among these patients median age was 9 years, duration of chronic kidney disease was 7 years and age at first visit with a urologist was less than 1 year. Of the patients 67% were male, 67% were white and 21% had a low birth weight. Median height was in the 24th percentile. Median glomerular filtration rate as measured by iohexol plasma disappearance was 44.8 ml/min/1.73 m2. Median glomerular filtration rate as estimated by the Chronic Kidney Disease in Children bedside equation was 44.3 ml/min/1.73 m2 (bias = −0.5, 95% CI −1.7 to 0.7, p = 0.44).
Underlying urological causes of chronic kidney disease were present in 59% of study participants. These children were diagnosed early in life, and many had low birth weight and growth delay. There is good agreement between the newly developed Chronic Kidney Disease in Children estimating equations and measured glomerular filtration rate in this population.
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