Risk Factors for the Progression of Pediatric Chronic Kidney Disease-A Single Center Study

ABSTRACT

PURPOSE: The progressive deterioration of renal function in children can impose a serious and lifelong impact on their lives. The ultimate goal in the management of children with chronic kidney disease(CKD) is to prolong survival, to prevent complications, and to promote growth and neurodevelopment. The aim of this study is to investigate the risk factors for the decline of renal function in pediatric CKD patients. METHODS: Data from patients who met the criteria for the Kidney Disease Outcomes Quality Initiative(K/DOQI) CKD stage 2 to 4 between August 1999 and March 2007 were retrospectively analyzed. The estimated glomerular filtration rate(eGFR) was calculated by the Schwartz formula, using serum creatinine levels and height. We calculated the annual eGFR change from the difference between the baseline eGFR and the last eGFR divided by the duration(years) of the follow-up period. We analyzed the association between the annual eGFR change and factors such as age, gender, K/DOQI stage, underlying renal disease, serum calcium, and inorganic phosphorous during the follow-up period. RESULTS: Sixty one children(44 boys & 17 girls) were enrolled. The age at entry was 7.1+/-4.7 years. The annual eGFR change was -1.2+/-11.9 mL/min/1.73m2/year. Our study showed that older age(P=0.005), hypocalcemia(P=0.012), and hyperphosphatemia(P=0.002) were significantly related to more rapid decline in renal function. CONCLUSION: In pediatric CKD, older age, hypocalcemia and hyperphosphatemia are related to more rapid deterioration of renal function.