Original Article

Pediatric Nephrology

, Volume 23, Issue 11, pp 2039-2046

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

  • Cristina M. Bouissou SoaresAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , José Silvério S. DinizAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , Eleonora M. LimaAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , Jose M. Penido SilvaAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , Gilce R. OliveiraAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , Monica R. CanhestroAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , Enrico A. ColosimoAffiliated withDepartment of Statistics, Hospital das Clínicas, Federal University of Minas Gerais (UFMG)
  • , Ana Cristina Simoes e SilvaAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)
  • , Eduardo A. OliveiraAffiliated withPediatric Nephrourology Unit, Federal University of Minas Gerais (UFMG)Rua Engenheiro Amaro Lanari 389/501 Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

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.

Keywords

Chronic kidney disease Chronic renal insufficiency Proteinuria Glomerulonephritis Outcome