Progression of pediatric CKD of nonglomerular origin in the CKiD cohort

Sahar A. Fathallah-Shaykh, Joseph T. Flynn, Christopher B. Pierce, Alison G. Abraham, Tom D. Blydt-Hansen, Susan F. Massengill, Marva M. Moxey-Mims, Bradley A. Warady, Susan L. Furth, Craig S. Wong

Research output: Contribution to journalArticle

Abstract

Background and objectives Congenital anomalies of the kidney and urinary tract and genetic disorders cause most cases of CKD in children. This study evaluated the relationships between baseline proteinuria and BP and longitudinal changes in GFR in children with these nonglomerular causes of CKD. Design, setting, participants, & measurements Urine protein-to-creatinine ratio, casual systolic and diastolic BP (normalized for age, sex, and height), and GFR decline were assessed in the prospective CKD in Children cohort study. Results A total of 522 children, median age 10 years (interquartile range, 7, 14 years) with nonglomerular CKD were followed for a median of 4.4 years. The mean baseline GFR in the cohort was 52 ml/min per 1.73 m2 (95% confidence interval [95% CI], 50 to 54) and declined 1.3 ml/min per 1.73 m2 per year on average (95%CI, 1.6 to 1.1). A 2-fold higher baseline urine protein-to-creatinine ratio was associated with an accelerated GFR decline of 0.3 ml/min per 1.73 m2 per year (95% CI, 0.4 to 0.1). A 1-unit higher baseline systolic BP z-score was associated with an additional GFR decline of 0.4 ml/min per 1.73 m2 per year (95% CI, 0.7 to 0.1). Among normotensive children, larger GFR declines were associated with larger baseline urine protein-to-creatinine ratios; eGFR declines of 0.8 and 1.8 ml/min per 1.73 m2 per year were associated with urine protein-to-creatinine ratio

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume10
Issue number4
DOIs
StatePublished - 2015

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Pediatrics
Creatinine
Urine
Confidence Intervals
Proteins
Inborn Genetic Diseases
Proteinuria
Cohort Studies

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

Progression of pediatric CKD of nonglomerular origin in the CKiD cohort. / Fathallah-Shaykh, Sahar A.; Flynn, Joseph T.; Pierce, Christopher B.; Abraham, Alison G.; Blydt-Hansen, Tom D.; Massengill, Susan F.; Moxey-Mims, Marva M.; Warady, Bradley A.; Furth, Susan L.; Wong, Craig S.

In: Clinical Journal of the American Society of Nephrology, Vol. 10, No. 4, 2015, p. 571-577.

Research output: Contribution to journalArticle

Fathallah-Shaykh, SA, Flynn, JT, Pierce, CB, Abraham, AG, Blydt-Hansen, TD, Massengill, SF, Moxey-Mims, MM, Warady, BA, Furth, SL & Wong, CS 2015, 'Progression of pediatric CKD of nonglomerular origin in the CKiD cohort', Clinical Journal of the American Society of Nephrology, vol. 10, no. 4, pp. 571-577. https://doi.org/10.2215/CJN.07480714
Fathallah-Shaykh, Sahar A. ; Flynn, Joseph T. ; Pierce, Christopher B. ; Abraham, Alison G. ; Blydt-Hansen, Tom D. ; Massengill, Susan F. ; Moxey-Mims, Marva M. ; Warady, Bradley A. ; Furth, Susan L. ; Wong, Craig S. / Progression of pediatric CKD of nonglomerular origin in the CKiD cohort. In: Clinical Journal of the American Society of Nephrology. 2015 ; Vol. 10, No. 4. pp. 571-577.
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AU - Fathallah-Shaykh, Sahar A.

AU - Flynn, Joseph T.

AU - Pierce, Christopher B.

AU - Abraham, Alison G.

AU - Blydt-Hansen, Tom D.

AU - Massengill, Susan F.

AU - Moxey-Mims, Marva M.

AU - Warady, Bradley A.

AU - Furth, Susan L.

AU - Wong, Craig S.

PY - 2015

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N2 - Background and objectives Congenital anomalies of the kidney and urinary tract and genetic disorders cause most cases of CKD in children. This study evaluated the relationships between baseline proteinuria and BP and longitudinal changes in GFR in children with these nonglomerular causes of CKD. Design, setting, participants, & measurements Urine protein-to-creatinine ratio, casual systolic and diastolic BP (normalized for age, sex, and height), and GFR decline were assessed in the prospective CKD in Children cohort study. Results A total of 522 children, median age 10 years (interquartile range, 7, 14 years) with nonglomerular CKD were followed for a median of 4.4 years. The mean baseline GFR in the cohort was 52 ml/min per 1.73 m2 (95% confidence interval [95% CI], 50 to 54) and declined 1.3 ml/min per 1.73 m2 per year on average (95%CI, 1.6 to 1.1). A 2-fold higher baseline urine protein-to-creatinine ratio was associated with an accelerated GFR decline of 0.3 ml/min per 1.73 m2 per year (95% CI, 0.4 to 0.1). A 1-unit higher baseline systolic BP z-score was associated with an additional GFR decline of 0.4 ml/min per 1.73 m2 per year (95% CI, 0.7 to 0.1). Among normotensive children, larger GFR declines were associated with larger baseline urine protein-to-creatinine ratios; eGFR declines of 0.8 and 1.8 ml/min per 1.73 m2 per year were associated with urine protein-to-creatinine ratio

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