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Chronic Kidney Disease (CKD): An Observational Study of Etiology, Severity and Burden of Comorbidities
Nivedita Kamath1, Arpana Aprameya Iyengar2
1Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, 560034, India.
Insights
Congenital anomalies of the kidney and urinary tract (CAKUT) are the main cause of pediatric chronic kidney disease (CKD). Many children with CKD experience significant comorbidities, even in early stages.
Area of Science:
- Pediatric Nephrology
- Renal Medicine
- Public Health
Background:
- Chronic kidney disease (CKD) in children presents unique challenges regarding etiology and management.
- Understanding the spectrum of comorbidities is crucial for effective patient care and prognosis.
Purpose of the Study:
- To investigate the primary causes (etiology) of CKD in children.
- To assess the prevalence and impact of associated health conditions (comorbidities) across different stages of pediatric CKD.
Main Methods:
- A cohort of 78 children aged 2-16 years with CKD Stages II-IV was studied over 12 months.
- Data collected included etiology, clinical presentation, and severity of complications.
Main Results:
- Congenital anomalies of the kidney and urinary tract (CAKUT) were the most frequent cause of CKD.
- High rates of comorbidities were observed, including growth retardation (65%), hypertension (59%), vitamin D deficiency (92%), and dyslipidemia (64%).
- Hypertension, vitamin D deficiency, and cardiovascular issues were common even in early CKD stages.
Conclusions:
- CAKUT is the leading cause of CKD in the studied pediatric population.
- Late diagnosis of CKD and a high burden of comorbidities, even in early stages, are significant concerns.
Objectives:
To study the etiology and burden of comorbidities across stages of chronic kidney disease (CKD).
Methods:
Children, 2-16 y of age with CKD Stages II- IV were recruited over 12 mo. The etiology, clinical presentation and severity of complications were studied.
Results:
Among 78 children [Stage II (n = 21), Stage III (n = 26), Stage IV (n = 31)], congenital anomalies of the kidney and urinary tract (CAKUT) was the commonest etiology and 28 were newly diagnosed in Stage III /IV. High prevalence of comorbidities was observed with growth retardation (65%), hypertension (59%), hyperphosphatemia (32%), vitamin D deficiency (92%), dyslipidemia (64%), left ventricular hypertrophy (45%) and hyperparathyroidism (56%). While most comorbidities correlated with the estimated glomerular filtration rate and severity of CKD, hypertension, vitamin D deficiency and cardiovascular morbidity were prevalent even in early stages.
Conclusions:
CAKUT was the commonest cause of CKD. Late detection and high prevalence of comorbidities even in early stages of CKD were observed.
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There are three types of observational studies – Prospective, retrospective, and cross-sectional.
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