Development of a risk score for earlier diagnosis of chronic kidney disease in children
| Autor: | Clotilde Druck Garcia, Samira Shizuko Parreao Oi, Káthia Liliane da Cunha Ribeiro Zuntini, Oreste Angelo Ferra Neto, Marcelo de Sousa Tavares, Paulo Cesar Koch Nogueira, Marina da Rocha Lordelo, Isabel de Pádua Paz, Tulio Konstantyner, Renata Trindade Damasceno, Vera Maria Santoro Belangero, Ricardo Sesso, Maria Fernanda Camargo de Carvalho, Cristine Campos de Xavier Pinto |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Urinary system Science 030232 urology & nephrology Renal function Physical examination 030204 cardiovascular system & hematology urologic and male genital diseases Risk Assessment 03 medical and health sciences Young Adult 0302 clinical medicine Pregnancy Medicine Nocturia Humans Medical history Renal Insufficiency Chronic Child Multidisciplinary Framingham Risk Score medicine.diagnostic_test business.industry Case-control study Infant Newborn Infant medicine.disease female genital diseases and pregnancy complications Early Diagnosis Case-Control Studies Child Preschool Disease Progression Female medicine.symptom business Brazil Kidney disease Glomerular Filtration Rate |
| Zdroj: | PLoS ONE, Vol 14, Iss 4, p e0215100 (2019) |
| ISSN: | 1932-6203 |
| Popis: | ObjectiveTo develop a clinical score for the early identification of chronic kidney disease (CKD) in children and adolescents. The early diagnosis of CKD in childhood allows the adoption of measures to slow the progression of the disease, thereby reducing morbidity and mortality. Nevertheless, the diagnosis is often made too late for proper patient management.Study designWe preformed a case-control study of a multicenter Brazilian sample of 752 pediatric patients; the study cases (n = 376) were CKD patients with a median estimated GFR of 37 (IQR = 22 to 57) ml/min/1.73 m2. The control group (n = 376) comprised age-, gender- and center-matched children who were followed for nonrenal diseases. Potential risk factors were investigated through a standard questionnaire that included symptoms, medical history, and a clinical examination. Two multivariable models (A and B) were fitted to assess predictors of the diagnosis of CKD.ResultsIn model A, 9 variables were associated with CKD diagnosis: antenatal ultrasound with urinary malformation, recurrent urinary tract infection, polyuria, abnormal urine stream, nocturia, growth curve flattening, history of hypertension, foamy urine and edema (c-statistic = 0.938). Model B had the same variables as model A, except for the addition of the history of admission during the neonatal period and the exclusion of antenatal ultrasound variables (c-statistic = 0.927).ConclusionsThe present scores may serve as a warning sign for CKD diagnosis in children among professionals working in the primary care setting where the symptoms associated with a risk of CKD may be overlooked. |
| Databáze: | OpenAIRE |
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