TITLE

Clinical outcome of children with chronic kidney disease in a pre-dialysis interdisciplinary program

AUTHOR(S)
Bouissou Soares, Cristina M.; Diniz, José Silvério S.; Lima, Eleonora M.; Penido Silva, Jose M.; Oliveira, Gilce R.; Canhestro, Monica R.; Colosimo, Enrico A.; Simoes e Silva, Ana Cristina; Oliveira, Eduardo A.
PUB. DATE
November 2008
SOURCE
Pediatric Nephrology;Nov2008, Vol. 23 Issue 11, p2039
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The purpose of this retrospective cohort study was to describe the outcome of 107 patients with chronic kidney disease (CKD) admitted to a pre-dialysis interdisciplinary management program from 1990 to 2006. The events of interest were progression to CKD stage 5 (renal survival), patient survival, hypertension, and somatic growth. Survival was studied by the Kaplan–Meier method. Patients were classified into four groups according to their primary renal disease: congenital nephro-uropathies; glomerular diseases; cystic disease, and miscellaneous. Median follow-up time was 94 months [Interquartile (IQ) range 38–145]. The probability of reaching CKD stage 5 was estimated to be 36% by 5 years after admission. As a whole, the mean estimated glomerular filtration rate (GFR) decrease per year was 5.8 ml/min per 1.73 m2 body surface area [standard deviation (SD) 12.4]. The glomerular diseases group showed a median rate of GFR deterioration of 10 ml/min per 1.73 m2 per year (IQ range −24 to −5.7), whereas the median rate of GFR deterioration for the groups with cystic diseases, congenital nephro-uropathies, and miscellanea were 2.5 ml/min (IQ range −10 to +0.34), 2.2 ml/min (IQ range −5.0 to −0.52), and 0.36 ml/min (IQ range −2.5 to +2.6), respectively ( P < 0.001). The results of this study support the view that children and adolescents with glomerular diseases present a faster deterioration of renal function. Therefore, patients with glomerular diseases need to be referred early to a pediatric nephrology center so that suboptimal pre-dialysis care might possibly be avoided.
ACCESSION #
34483460

 

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