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Clinical outcome of children with chronic kidney disease in a pre-dialysis interdisciplinary program

Cristina M Bouissou Soares1, José Silvério S Diniz, Eleonora M Lima

  • 1Pediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG), MG, Brazil.

Pediatric Nephrology (Berlin, Germany)
|June 19, 2008
PubMed

Insights

Children with glomerular diseases experience faster chronic kidney disease (CKD) progression. Early referral to pediatric nephrology centers is crucial for optimal pre-dialysis care in these patients.

Area of Science:

  • Pediatric Nephrology
  • Renal Medicine
  • Chronic Kidney Disease Management

Background:

  • Chronic kidney disease (CKD) affects children and adolescents, necessitating specialized management programs.
  • Pre-dialysis interdisciplinary programs aim to slow disease progression and improve patient outcomes.
  • Understanding the differential progression rates based on etiology is critical for tailored interventions.

Purpose of the Study:

  • To describe the outcomes of pediatric patients with CKD in a pre-dialysis interdisciplinary management program.
  • To analyze renal survival, patient survival, hypertension, and somatic growth.
  • To compare the rate of estimated glomerular filtration rate (GFR) decline across different primary renal disease classifications.

Main Methods:

  • Retrospective cohort study of 107 patients with CKD admitted between 1990 and 2006.
  • Kaplan-Meier method used for survival analysis.
  • Patients categorized into four groups: congenital nephro-uropathies, glomerular diseases, cystic disease, and miscellaneous.

Main Results:

  • The overall mean GFR decrease was 5.8 ml/min/1.73 m(2)/year.
  • Patients with glomerular diseases exhibited a significantly faster median GFR deterioration rate (10 ml/min/1.73 m(2)/year) compared to other groups (P < 0.001).
  • The probability of reaching CKD stage 5 within 5 years was 36%.

Conclusions:

  • Glomerular diseases are associated with a more rapid decline in renal function in pediatric CKD patients.
  • Early referral to pediatric nephrology centers is recommended for children with glomerular diseases.
  • Timely intervention may help avoid suboptimal pre-dialysis care and improve long-term outcomes.

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