Tobacco exposure in children and adolescents with chronic kidney disease: parental behavior and knowledge. A study from the Midwest Pediatric Nephrology Consortium

The study aimed to summarize data of Chronic Kidney Disease (CKD) in children and adolescents in Ukraine. Methods. There were performed a qualitative study based on published documents and registers, and a cohort observational study included 3528 depersonalized patients with CKD diagnosed before the age of 18. That was used cross-sectional and longitudinal design for the structure, etiology, and outcomes analysis, period comparison (years 2014 and 2019), quantitative analyzes depending on patients age and nosology, risk measurements and survival function. Results. There was found the tendency to reduce the incidence of the genitourinary system diseases in childhood, and the predominance of these classes of diseases in adolescents. The main causes of CKD were congenital structural or histological abnormalities and glomerulonephritis. Prolonged kidney function preservation at the initial level was confirmed in many patients (CKD1 was maintained in 33.0% and CKD5 - in 56.6% causes after 5 years period) with the partial function improvement in CKD1-3. CKD1-4 probability at the 1st year of observation was 91.7±0.47%, at the 5th year - 84.2±0.82%. The structural CKD5 specialties in patients receiving Kidney Replacement Therapy have been established. There was a significantly higher risk of CKD5 during 5 years period after Acute Kidney Injury (OR 2.81-2.10), and a lower probability of CKD5 in patients with glomerulonephritis (OR 0.66-0.54) compared to other nosology. CKD pathomorphosis was found in the year 2019 compared to the year 2014: the kidney dysplasia as an etiological factor was increased (from 19.3% to 22.0%, р=0.040); the immediate outcome at the 1st year of observation was improved with the lower risk of declaring of Glomerular Filtration Rate (GFR) to CKD5 level (93.6% vs. 90.0%), but the late follow-up prognosis became worse (the cumulative probability of CKD1-4 at the 5th year of observation decreased from 85.5 to 73.9%, p=0.016); the structure of Kidney Replacement Therapy changed with the increasing part of transplanted patients (from 30.5% to 48.9%, p<0.001), especially as a first choice (pre-dialysis); the tendency to decrease the proportion of polycystic kidney disease in CKD and to increase it in CKD5 was revealed with risk raising of GFR loss <15 ml/min in the year 2019 compared to other nosology (OR 1.69, p=0.027). Conclusions. The established epidemiological and clinical realities are important for determining the kidney disease outcome in children and adolescents, assessing the medical management of these patients, sharpening the priorities of pediatric nephrology, and emphasizing the significance of further studies with appropriate regulations.

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Determinants of the intima–media thickness in children and adolescents with chronic kidney disease

Pediatric Nephrology ◽

10.1007/s00467-007-0733-6 ◽

2008 ◽

Vol 23 (5) ◽

pp. 805-811 ◽

Cited By ~ 17

Author(s):

Helena Ziolkowska ◽

Michal Brzewski ◽

Maria Roszkowska-Blaim

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Children And Adolescents ◽

Intima Media Thickness ◽

Media Thickness

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The individualized, accompanied transition program “TraiN” for adolescent kidney patients – a local initiative

Journal of Transition Medicine ◽

10.1515/jtm-2021-0002 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Paula Collette ◽

Luisa C. Klein ◽

Lisa M. Körner ◽

Gundula Ernst ◽

Sandra Brengmann ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Disease Management ◽

Health Risks ◽

Pediatric Nephrology ◽

Young Patients ◽

Transition Program ◽

University Hospital ◽

Adult Care ◽

Local Initiative

Abstract Since the transition from pediatric and adolescent to adult care often proceeds unaccompanied and unplanned, young patients with chronic kidney disease may experience health risks and non-adherence after the transfer. The psychosocial team at the Department of Pediatric Nephrology at the University Hospital of Cologne has therefore developed its local transition program “TraiN” for patients with chronic kidney disease aged 13 years and older. It combines structure and flexibility through predefined content modules that can be individually adapted to the patients, offering continuity and sustainability through a transition contact person. In addition, the family members are offered regular psychological consultations. The timing of the transfer is chosen individually depending on the level of psychosocial and medical transition readiness. The aim of “TraiN” is to strengthen the patients’ transition competence and the responsibility for their disease management and to provide them and their families the best possible support during the transition in order to prevent possible health risks. In the near future, a scientific evaluation will be conducted aiming to determine whether “TraiN” can support young people in their independence and self-reliant disease management.

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Quality of life of children and adolescents with chronic kidney disease: a cross-sectional study

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-314934 ◽

2018 ◽

Vol 104 (2) ◽

pp. 134-140 ◽

Cited By ~ 9

Author(s):

Anna Francis ◽

Madeleine S Didsbury ◽

Anita van Zwieten ◽

Kerry Chen ◽

Laura J James ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Children And Adolescents ◽

Family Income ◽

Cross Sectional Study ◽

Kidney Transplants ◽

Cross Sectional ◽

Factors Associated

ObjectiveThe aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL.DesignCross-sectional.SettingThe Kids with CKD study involved five of eight paediatric nephrology units in Australia and New Zealand.PatientsThere were 375 children and adolescents (aged 6–18 years) with CKD, on dialysis or transplanted, recruited between 2013 and 2016.Main outcome measuresOverall and domain-specific QoL were measured using the Health Utilities Index 3 score, with a scale from −0.36 (worse than dead) to 1 (perfect health). QoL scores were compared between CKD stages using the Mann-Whitney U test. Factors associated with changes in QoL were assessed using multivariable linear and ordinal logistic regression.ResultsQoL for those with CKD stages 1–2 (n=106, median 0.88, IQR 0.63–0.96) was higher than those on dialysis (n=43, median 0.67, IQR 0.39–0.91, p<0.001), and similar to those with kidney transplants (n=135, median 0.83, IQR 0.59–0.97, p=0.4) or CKD stages 3–5 (n=91, 0.85, IQR 0.60–0.98). Reductions were most frequent in the domains of cognition (50%), pain (42%) and emotion (40%). The risk factors associated with decrements in overall QoL were being on dialysis (decrement of 0.13, 95% CI 0.02 to 0.25, p=0.02), lower family income (decrement of 0.10, 95% CI 0.03 to 0.15, p=0.002) and short stature (decrement of 0.09, 95% CI 0.01 to 0.16, p=0.02).ConclusionsThe overall QoL and domains such as pain and emotion are substantially worse in children on dialysis compared with earlier stage CKD and those with kidney transplants.

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Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease

Clinical and Experimental Nephrology ◽

10.1007/s10157-013-0856-y ◽

2013 ◽

Vol 18 (4) ◽

pp. 626-633 ◽

Cited By ~ 95

Author(s):

Osamu Uemura ◽

Takuhito Nagai ◽

Kenji Ishikura ◽

Shuichi Ito ◽

Hiroshi Hataya ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Glomerular Filtration Rate ◽

Kidney Disease ◽

Children And Adolescents ◽

Glomerular Filtration ◽

Filtration Rate ◽

Japanese Children

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Renal hypertension and cardiovascular disorder in children with chronic kidney disease

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1402113p ◽

2014 ◽

Vol 142 (1-2) ◽

pp. 113-117 ◽

Cited By ~ 2

Author(s):

Amira Peco-Antic ◽

Dusan Paripovic

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Children And Adolescents ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Renal Hypertension ◽

Masked Hypertension ◽

Ambulatory Blood Pressure Measurement

Renal hypertension is one of the earliest and the most prevalent complications of pediatric chronic kidney disease (CKD). Among renal patients, hypertension is frequently underdiagnosed and undertreated. For casual blood pressure measurement, the best method is auscultatory, while for ambulatory blood pressure measurement, oscillometric method is the most commonly used. Both casual and ambulatory blood pressure measurement provide more powerful means of diagnosing hypertension. Masked hypertension is a condition in which casual blood pressure is normal but ambulatory blood pressure is elevated. The risk of cardiovascular morbidity and mortality is higher with masked hypertension as compared to the controls. Children and adolescents with CKD are at high risk of cardiovascular disease that has been established as the leading cause of death in patients with end stage renal disease. Left ventricular hypertrophy remains the most thoroughly documented form of end-organ damage caused by hypertension in children and adolescents with CKD. Based on clear evidence on the correlation between blood pressure and cardiovascular morbidity, mortality, and renal function, renal hypertension must be aggressively treated. Target blood pressure for patients with renal hypertension should be at low normal values: <75 percentile for patients without proteinuria and <50 percentile for patients with proteinuria. Renin-angiotensin system antagonists are considered the first choice pharmacological option in hypertensive CKD 2-4 patients while the management of volume overload is the most important in dialysis patients. Successful transplantation can eliminate or significantly improve uremia-related cardiovascular risk factors and increase predicted life expectancy.

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Etiologic-sociodemographic assessment and comparison of dialysis modalities in pediatric Syrian migrants with chronic kidney disease

Brazilian Journal of Nephrology ◽

10.1590/2175-8239-jbn-2020-0260 ◽

2021 ◽

Author(s):

Mehtap Çelakıl ◽

Yasemin Çoban

Keyword(s):

Chronic Kidney Disease ◽

Peritoneal Dialysis ◽

Kidney Disease ◽

Clinical Laboratory ◽

Kidney Diseases ◽

Pediatric Nephrology ◽

Refugee Children ◽

Mortality And Morbidity ◽

Ventricle Hypertrophy ◽

Hospital Pediatric

Abstract Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are among the important causes of mortality and morbidity in childhood. Early diagnosis and treatment of the underlying primary disease may prevent most of CKD patients from progressing to ESRD. There is no study examining chronic kidney diseases and dialysis modalities in Syrian immigrant children. We aimed to retrospectively research the etiologic, sociodemographic, and clinical factors in CKD among Syrian refugee children, and at the same time, to compare the clinical characteristics of patients with ESRD on peritoneal dialysis and hemodialysis. Methods: Our study included a total of 79 pediatric Syrian patients aged from 2-16 years monitored at Hatay State Hospital pediatric nephrology clinic with diagnosis of various stages of CKD and with ESRD. Physical-demographic features and clinical-laboratory information were retrospectively screened. Results: The most common cause of CKD was congenital anomalies of the kidneys and urinary tracts (CAKUT) (37.9%). Other causes were urolitiasis (15.1%), nephrotic syndrome (10.1%), spina bifida (8.8%), hemolytic uremic syndrome (7.5%), and glomerulonephritis (7.5%). Twenty-five patients used hemodialysis due to bad living conditions. Only 2 of the patients with peritoneal dialysis were using automatic peritoneal dialysis (APD), with 5 using continuous ambulatory peritoneal dialysis (CAPD). Long-term complications like left ventricle hypertrophy and retinopathy were significantly higher among hemodialysis patients. There was no difference identified between the groups in terms of hypertension and sex. Conclusion: Progression to ESRD due to preventable reasons is very frequent among CKD patients. For more effective use of peritoneal dialysis in pediatric patients, the responsibility of states must be improved.

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