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5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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Preserved renal function during long-term follow-up in children with chronic liver disease

Ulla B Berg1, Henrike Häbel2, Antal Németh3

  • 1Division of Paediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|February 21, 2022
PubMed

Insights

Children with chronic liver disease generally maintain good kidney function long-term. Early hyperfiltration may indicate future decline, highlighting the need for regular renal monitoring in pediatric liver disease patients.

Area of Science:

  • Pediatric Nephrology
  • Hepatology
  • Chronic Liver Disease Research

Background:

  • Previous research indicated well-maintained renal function in children with new-onset chronic liver disease.
  • Long-term renal function in this cohort required further investigation.

Purpose of the Study:

  • To investigate the long-term renal function in children diagnosed with chronic liver disease.
  • To identify potential predictors of renal function decline in pediatric chronic liver disease.

Main Methods:

  • A longitudinal study involving 289 children with chronic liver disease.
  • Glomerular filtration rate (GFR) was assessed annually using inulin or iohexol clearance.
  • Linear mixed-effects models analyzed yearly GFR changes across disease subgroups and outcomes.

Main Results:

  • Most children maintained good renal function throughout the study period, even with progressive liver disease.
  • The most significant decline in GFR was observed in patients initially presenting with hyperfiltration.
  • Cholestasis appeared to have a protective effect on kidney function.

Conclusions:

  • Chronic liver disease in childhood may have a lesser impact on renal function than previously thought, particularly when liver function is compensated.
  • Regular renal function monitoring is crucial for managing pediatric patients with chronic liver disease.
  • Initial hyperfiltration is a potential predictor of declining renal function, but other prognostic markers were not identified in non-decompensated cases.
Abstract

Keywords:
chronic liver diseaseclearance of inulin or iohexolglomerular filtration rateinfants and children

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