Longitudinal progression trajectory of estimated glomerular filtration rate in children with chronic kidney disease: results from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease).

Autor: Yang EM; Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea., Kim J; Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea., Park E; Department of Pediatrics, Korea University Guro Hospital, Seoul, Republic of Korea., Han KH; Department of Pediatrics, College of Medicine, Jeju National University, Jeju, Republic of Korea., Kim SH; Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea., Cho H; Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Shin JI; Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.; Division of Pediatric Nephrology, Severance Children's Hospital, Seoul, Republic of Korea., Cho MH; Department of Pediatrics, Kyungpook National University School of Medicine, Daegu, Republic of Korea., Lee JH; Department of Pediatrics, Asan Medical Center Children's Hospital, Ulsan University, College of Medicine, Seoul, Republic of Korea., Kim JH; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.; Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea., Kang HG; Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.; Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.; Wide River Institute of Immunology, Seoul National University, Hongcheon, Republic of Korea., Ha IS; Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea., Ahn YH; Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.; Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea.; Kidney Research Institute, Medical Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jazyk: angličtina
Zdroj: Kidney research and clinical practice [Kidney Res Clin Pract] 2024 Feb 23. Date of Electronic Publication: 2024 Feb 23.
DOI: 10.23876/j.krcp.23.198
Abstrakt: Background: The natural course of chronic kidney disease (CKD) progression in children varies according to their underlying conditions. This study aims to identify different patterns of subsequent decline in kidney function and investigate factors associated with different patterns of estimated glomerular filtration rate (eGFR) trajectories.
Methods: We analyzed data from the KNOW-Ped CKD (KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease), which is a longitudinal, prospective cohort study. A latent class linear mixed model was applied to identify the trajectory groups.
Results: In a total of 287 patients, the median baseline eGFR (mL/min/1.73 m2) was 63.3, and the median age was 11.5 years. The eGFR decline rate was -1.54 during a 6.0-year follow-up. The eGFR trajectory over time was classified into four groups. Classes 1 (n = 103) and 2 (n = 11) had a slightly reduced eGFR at enrollment with a stable trend (ΔeGFR, 0.2/year) and a rapid decline eGFR over time (ΔeGFR, -10.5/year), respectively. Class 3 had a normal eGFR (n = 16), and class 4 had a moderately reduced eGFR (n = 157); both these chasses showed a linear decline in eGFR over time (ΔeGFR, -4.1 and -2.4/year). In comparison with classes 1 and 2, after adjusting for age, causes of primary renal disease, and baseline eGFR, nephrotic-range proteinuria was associated with a rapid decline in eGFR (odds ratio, 8.13).
Conclusion: We identified four clinically relevant subgroups of kidney function trajectories in children with CKD. Most children showed a linear decline in eGFR; however, there are different patterns of eGFR trajectories.
Databáze: MEDLINE