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Renal function in pediatric cystic fibrosis patients in the first decade of life

Chanel Prestidge1, Mark A Chilvers, A George F Davidson

  • 1Department of Pediatrics, Division of Nephrology, BC Children's Hospital, 4480 Oak Street, ACB K4-151, Vancouver, British Columbia, Canada.

Pediatric Nephrology (Berlin, Germany)
|December 31, 2010
PubMed

Insights

Cystic fibrosis (CF) patients show higher than normal kidney filtration rates, not significant impairment, despite potential medication effects. This study measured glomerular filtration rate (GFR) in children with CF.

Area of Science:

  • Nephrology
  • Pediatric Pulmonology
  • Pharmacology

Background:

  • Increasing life expectancy in cystic fibrosis (CF) patients leads to higher rates of chronic kidney disease (CKD).
  • Limited data exists on baseline or longitudinal glomerular filtration rate (GFR) in pediatric CF populations.
  • Exogenous clearance markers for GFR assessment are underutilized in this group.

Purpose of the Study:

  • To assess renal function in pediatric patients with cystic fibrosis (CF).
  • To determine the prevalence of chronic kidney disease (CKD) and measure glomerular filtration rate (GFR) using exogenous markers.
  • To investigate potential links between limited aminoglycoside exposure and renal function in CF.

Main Methods:

  • Retrospective cross-sectional study of 63 pediatric patients (2-18 years) at a single CF center.
  • GFR measured via plasma disappearance of Technetium-99 m diethylenetriaminepentaacetic acid (mGFR).
  • Renal dysfunction defined as CKD stage II or below, abnormal urinary sediment, or renal imaging.

Main Results:

  • Four out of 63 patients exhibited signs of renal dysfunction (one with decreased mGFR, three with microscopic hematuria).
  • Mean mGFR was significantly elevated at 140 ± 24 ml/min/1.73 m(2), exceeding expected values for healthy children.
  • No significant renal impairment was detected following limited aminoglycoside exposure in the first decade post-CF diagnosis.

Conclusions:

  • The study did not find significant renal impairment in pediatric CF patients with limited aminoglycoside exposure.
  • Glomerular hyperfiltration was documented in a notable proportion of the studied CF population.
  • Further research is needed to understand the long-term renal implications of hyperfiltration in CF.

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