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CKiD (CKD in children) prospective cohort study: a review of current findings
Cynthia J Wong1, Marva Moxey-Mims, Judith Jerry-Fluker
1Department of Pediatrics, Division of Nephrology, Lucile Packard Children's Hospital, Palo Alto, CA, USA. wongcy8@stanford.edu
Insights
Chronic kidney disease (CKD) in children is rising, impacting growth and neurocognition. Early intervention is crucial for better long-term health outcomes in pediatric CKD patients.
Area of Science:
- Pediatric Nephrology
- Chronic Disease Epidemiology
Background:
- Chronic kidney disease (CKD) is a progressive condition with increasing global incidence in children.
- CKD in pediatric populations leads to significant morbidity, including cardiovascular disease and cognitive impairment, mirroring adult complications.
Observation:
- The Chronic Kidney Disease in Children (CKiD) Study is a prospective cohort of 586 children (ages 1-16) with CKD.
- CKiD research has identified key risk factors for CKD progression and associated cardiovascular disease in children.
- The study highlights CKD's unique impact on pediatric neurocognitive development and growth.
Findings:
- CKD complications in children are diverse, affecting multiple organ systems and developmental trajectories.
- Cardiovascular disease and neurocognitive deficits are highly prevalent comorbidities in children with CKD.
- Risk factors for CKD progression and cardiovascular disease have been identified in the pediatric cohort.
Implications:
- Initiating therapeutic interventions at an early age is essential for mitigating long-term morbidity and mortality in children with CKD.
- Further research is needed to fully understand and address the spectrum of CKD-associated complications in children.
- Early management strategies are critical for improving overall health outcomes and quality of life for pediatric CKD patients.
Abstract:
Chronic kidney disease (CKD) is a life-long condition associated with substantial morbidity and premature death due to complications from a progressive decrease in kidney function. The incidence and prevalence of all stages of CKD in children continues to increase worldwide. Between 2000 and 2008, the kidney replacement therapy incidence rate in those aged 0-19 years increased 5.9% to 15 per million population, highlighting the importance of CKD research in children. Many comorbid conditions seen in adults with CKD, including cardiovascular disease and cognitive impairment, also are highly prevalent in children, implicitly demonstrating the crucial need for initiating therapy early to improve health outcomes in children with CKD. The CKiD (Chronic Kidney Disease in Children) Study is a prospective cohort study of 586 children aged 1-16 years with an estimated glomerular filtration rate of 30-90 mL/min/1.73 m(2). Since its inception, CKiD has identified risk factors for CKD progression and cardiovascular disease in children with CKD and highlighted the effects of CKD on outcomes unique to children, including neurocognitive development and growth. This review summarizes the findings to date, illustrating the spectrum of CKD-associated complications in children and emphasizing areas requiring further investigation. Taken in sum, these elements stress that initiating treatment at an early age is essential for reducing long-term morbidity and mortality in children with CKD.
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