Pediatric Nephrology

, 23:2039

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

  • Cristina M. Bouissou Soares
  • José Silvério S. Diniz
  • Eleonora M. Lima
  • Jose M. Penido Silva
  • Gilce R. Oliveira
  • Monica R. Canhestro
  • Enrico A. Colosimo
  • Ana Cristina Simoes e Silva
  • Eduardo A. Oliveira
Original 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.

Keywords

Chronic kidney disease Chronic renal insufficiency Proteinuria Glomerulonephritis Outcome 

Copyright information

© IPNA 2008

Authors and Affiliations

  • Cristina M. Bouissou Soares
    • 1
  • José Silvério S. Diniz
    • 1
  • Eleonora M. Lima
    • 1
  • Jose M. Penido Silva
    • 1
  • Gilce R. Oliveira
    • 1
  • Monica R. Canhestro
    • 1
  • Enrico A. Colosimo
    • 2
  • Ana Cristina Simoes e Silva
    • 1
  • Eduardo A. Oliveira
    • 1
    • 3
  1. 1.Pediatric Nephrourology UnitFederal University of Minas Gerais (UFMG)Belo HorizonteBrazil
  2. 2.Department of Statistics, Hospital das ClínicasFederal University of Minas Gerais (UFMG)Belo HorizonteBrazil
  3. 3.Rua Engenheiro Amaro Lanari 389/501Belo HorizonteBrazil

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