Factors associated with long-term progression of pediatric chronic kidney disease of nonglomerular etiologies

Abstract

Background/purpose: The aims of this study were to determine the long-term associated factors for chronic kidney disease (CKD) progression in a pediatric group with non-glomerular (non-GN) etiologies.

Methods: Pediatric patients with a presumptive diagnosis of CKD were enrolled to this study. Recorded information included demographic and laboratory information. We included the patients with non-GN etiologies and investigated the factors including systolic and diastolic blood pressure (BP), proteinuria, and anemia status in association with reductions in the estimated glomerular filtration rate (eGFR).

Results: A total of 308 children were enrolled and the mean duration of follow-up was 4.40 ± 3.53 years. Median baseline age was 5 years old and the males represented 55% of all patients. One-unit increased baseline systolic BP z-score was associated with 1.2 ml/min per 1.73 m² (95% CI = -2 to -0.5) faster rate of eGFR decline. The presence of baseline proteinuria and anemia were also associated with 4.1 ml/min per 1.73 m² (95% CI = -5.7 to -2.5) and 2.2 ml/min per 1.73 m² (95% CI = -3.6 to -0.8) more rapid eGFR declination, respectively. Hypertension, anemia and proteinuria during the follow-up were also associated with 3.25 ml/min per 1.73 m² (95% CI = -5.32 to -1.18), 4.34 ml/min per 1.73 m² (95% CI = -7.25 to -1.43) and 4.97 ml/min per 1.73 m² (95% CI = -8.23 to -1.71) more rapid eGFR declination, respectively.

Conclusion: Elevated systolic BP, proteinuria, and anemia are independently associated with CKD progression in pediatric patients with non-GN etiologies.

Keywords: Children; Chronic kidney disease; Congenital anomalies of the kidney and the urinary tract; Progression.