Chronic Kidney Disease in Children: New Study Sheds Light on Factors Contributing to Decline in Kidney Function

Introduction

Chronic Kidney Disease (CKD) in children is a rare condition, making it difficult to study and leaving major gaps in the available evidence to inform the care of pediatric patients. Previous studies have been limited by selection bias and small sample sizes, making it challenging to draw meaningful conclusions.

Study Overview

A new study led by the Children's Hospital of Philadelphia (CHOP) and Nemours Children's Health has analyzed electronic health record data from PEDSnet, a national multicenter pediatric network, to identify a large cohort of children with CKD. The goal was to demonstrate that real-world EHR data can be used to model kidney function decline in children. The researchers focused on children from six pediatric health systems in the PEDSnet database seen between 2009 and 2022, identifying 11,240 (0.157%) with CKD.

Key Findings

The researchers found that several attributes were associated with a more rapid decline in kidney function in children with CKD:

• Disease of glomerular or malignancy-associated origins
• High levels of proteinuria (protein in the urine)
• Hypertension
• Younger age
• More advanced CKD
• Male sex
• Greater medical complexity at the start of follow-up care

For example, over an average follow-up time of five years, 40% of patients with glomerular CKD required long-term dialysis or transplant or experienced more than a 50% reduction in estimated glomerular filtration rate (eGFR), compared to only 13% of patients with non-glomerular CKD.

Implications

The findings of this study, which includes a large population of children with cancer and CKD, can be applied more broadly to the pediatric CKD population. Children with the risk factors identified are at greater risk of CKD progression and may be targeted for future comparative effectiveness studies to preserve kidney function. The study also serves as a roadmap for the use of EHR data networks to study rare diseases.

Conclusion

This study provides valuable insights into the factors contributing to the decline in kidney function in children with CKD and has the potential to inform future research and clinical decision-making. The use of real-world EHR data and the large sample size of this study make it a significant contribution to the understanding of pediatric CKD.

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Related Articles

What is Chronic Kidney Disease?

What Causes Chronic Kidney Disease?

‍What Do Your Kidneys Do?

Creatinine and eGFR; What Are They and Why Are They Important?

References

Large Study Identifies Risk Factors in Children with Chronic Kidney Disease

Evaluating Kidney Function Decline in Children with Chronic Kidney Disease Using a Multi-Institutional Electronic Health Record Database

‍About the Author

Rich Foreman brings over 30 years of technology leadership to his role of CEO and Co-Founder of KidneySoft.  As founding CTO, Rich led the team that developed the CordicoShield / CordicoFire Wellness App. Cordico was honored with the Sacramento Innovation Award in 2021. After achieving a 7 digit ARR, Cordico was acquired by Lexipol in 2020. Rich has a BS in Industrial Engineering from the University of Washington, an MPA from Troy State University and was an officer in the U.S. Navy. Rich co-authored his book, "Tap into the Mobile Economy." Rich's blog was listed in Top 20 Marketing Mobile Blogs of 2014. He has been featured on KCRA3, NEWS10, 1170 Tech AM PowerDrive, Business Radio Money 105.5, SiliconIndia, the Sacramento Business Journal, and the Sacramento Bee. Rich is also the Founding Director of the Sacramento Chapter of Startup Grind and served a term as Utility Commissioner for the City of Folsom. Rich is a regular contributor to TechWire.net and StartupSac. Rich was the Co-founder of Apptology which was named Small Business of the Year in 2014 by the Sacramento Asian Pacific Chamber. He was also the Founding Chief Technology Officer at Cordico. Cordico was acquired by Lexipol in 2020.  Rich also served 4 years as a Naval Officer in the Civil Engineer Corps.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.