Related Experiment Videos

Design and methods of the Chronic Kidney Disease in Children (CKiD) prospective cohort study

Susan L Furth1, Stephen R Cole, Marva Moxey-Mims

  • 1Department of Pediatrics, Johns Hopkins Children's Center, Baltimore MD, USA. sfurth@jhmi.edu

Clinical Journal of the American Society of Nephrology : CJASN
|August 19, 2007
PubMed

Insights

The Chronic Kidney Disease in Children (CKiD) study tracks pediatric kidney disease progression. This research aims to improve GFR estimation and understand CKD

Area of Science:

  • Pediatric Nephrology
  • Chronic Kidney Disease Research
  • Longitudinal Cohort Studies

Background:

  • An estimated 650,000 Americans faced End-Stage Renal Disease (ESRD) by 2010.
  • Progressive Chronic Kidney Disease (CKD) often begins in childhood and adolescence.
  • Pediatric CKD significantly impacts growth, cognition, behavior, and cardiovascular health.

Purpose of the Study:

  • To identify novel risk factors for CKD progression in children.
  • To assess the impact of declining kidney function on growth, cognition, and behavior.
  • To monitor the development of cardiovascular disease risk factors in pediatric CKD patients.

Main Methods:

  • The Chronic Kidney Disease in Children (CKiD) study enrolled 540 children (aged 1-16) with estimated GFR between 30-75 ml/min/1.73 m2.
  • Annual assessments include physical exams, Tanner staging, BP measurements, and questionnaires on cognition, quality of life, nutrition, and behavior.
  • Glomerular Filtration Rate (GFR) is measured using iohexol, HPLC creatinine, and cystatin C; echocardiography and ambulatory BP monitoring are conducted biennially.

Main Results:

  • The study aims to develop an improved pediatric GFR estimating formula using age, gender, Tanner stage, height, and creatinine.
  • Analysis of serial measurements will enhance longitudinal GFR estimation accuracy.
  • The primary outcome is the rate of GFR decline, providing critical data on disease progression.

Conclusions:

  • The CKiD study is the largest North American multicenter study focused on pediatric CKD.
  • Findings will advance understanding of CKD progression and its multifaceted effects in children.
  • The research is expected to improve clinical management and outcomes for young patients with kidney disease.

Related Concept Videos

Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...