Prospective cohort analyzing risk factors for chronic kidney disease progression in children

Belangero, Vera Maria Santoro; Prates, Liliane Cury; Watanabe, Andréia; Schvartsman, Benita S.G.; Nussenzveig, Paula; Cruz, Natalia A.; Abreu, Ana L.S.; Paz, Isabel Pavón de; Facincani, Inalda; Morgantetti, Fernanda E.C.; Silva, Andreia O.; Andrade, Olberes Vitor Braga de; Camargo, Maria Fernanda Carvalho de; Nogueira, Paulo Roberto

doi:10.1016/j.jped.2017.07.015

Cited by 9 publications

(4 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A 31% greater risk of CKD progression was noted in patients with high BP at first visit in the study. A one unit increase in Z-score for systolic BP at start of follow-up was associated with a 1.3-fold higher risk of attaining the combined outcome of the study (death or need for renal replacement therapy or 50% decline in estimated GFR) (15).…”

Section: Hypertension As a Risk Factormentioning

confidence: 99%

Management of Hypertension in CAKUT: Protective Factor for CKD

Gabriele

Nogueira

2019

Front. Pediatr.

View full text Add to dashboard Cite

Patients with congenital kidney and urinary tract abnormalities (CAKUT) will often develop end-stage renal disease at some point and the need for renal replacement therapy is associated with high rates of morbidity and mortality. Hence, efforts to slow the progression of the disease are essential. Hypertension has been proven to be an independent risk factor for faster decline of glomerular filtration rate in renal patients, but studies involving only children with CAKUT are scarce. We performed a literature review to explore the association of hypertension with faster chronic kidney disease progression in children with CAKUT and also treatment options in this condition. A recent study reported an annual decline in GFR of 1.8 ml/min/1.73 m 2 among hypertensive patients with non-glomerular CKD, compared with 0.8 ml/min/1.73 m 2 in normotensive children. A multicenter prospective cohort in Brazil showed that a 1-unit increase in systolic blood pressure Z-score was associated with a 1.5-fold higher risk of disease progression. Since renin-angiotensin-aldosterone system activation is the most important mechanism of hypertension in these children, the first-line therapy involves the use of inhibitors of this axis, including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers type I, which also promote an anti-fibrotic effect. Recent studies have shown a good safety profile for use in patients with chronic kidney disease and also in those with solitary kidneys. Hypertension is an independent risk factor for kidney disease progression and should be promptly managed for renal protection, especially among patients with CAKUT, the primary cause of chronic kidney disease in the pediatric population.

show abstract

Section: Hypertension As a Risk Factormentioning

confidence: 99%

Management of Hypertension in CAKUT: Protective Factor for CKD

Gabriele

Nogueira

2019

Front. Pediatr.

View full text Add to dashboard Cite

show abstract

“…In adults, CKD etiology frequently involves diabetes mellitus and high blood pressure, whereas in children and adolescents the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerular diseases [5][6][7]40 . A number of factors can cause CAKUT, with genetic factors, renal hypoplasia and dysplasia, and obstructive uropathies being the most common [4][5][6]38 .…”

Section: Introductionmentioning

confidence: 99%

Pediatric chronic kidney disease: blood cell count indexes as inflammation markers

Silva,

Santos Lopes,

Mota

et al. 2023

Braz. J. Nephrol.

View full text Add to dashboard Cite

Introduction: Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. Aim: To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). Methods: We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. Results: Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. Conclusion: The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.

show abstract

“…Em adultos, a etiologia da DRC frequentemente envolve diabetes mellitus e hipertensão arterial, enquanto em crianças e adolescentes os principais fatores desencadeantes são as anomalias congênitas dos rins e trato urinário (CAKUT) e as doenças glomerulares [5][6][7]40 . Vários fatores podem causar a CAKUT, sendo os mais comuns os fatores genéticos, a hipoplasia e a displasia renal e uropatias obstrutivas [4][5][6]38 .…”

Section: Introductionunclassified

Doença renal crônica pediátrica: índices de contagem de células sanguíneas como marcadores de inflamação

Silva,

Santos Lopes,

Mota

et al. 2023

Braz. J. Nephrol.

View full text Add to dashboard Cite

Resumo Introdução: Doença renal crônica (DRC) é definida como um declínio progressivo das funções renais. Na infância, os principais fatores desencadeantes são anomalias congênitas dos rins e trato urinário (CAKUT) e glomerulopatias. Respostas inflamatórias apresentam desafios para diagnóstico e estadiamento, o que justifica estudos sobre biomarcadores/índices. Objetivo: Definir índices de contagem de células sanguíneas e verificar sua associação com etiologia e estadiamento da DRC pediátrica. Os índices incluídos foram: Razão Neutrófilo-Linfócito (NLR), Razão Neutrófilo-Linfócito Derivada (dNLR), Razão Linfócito-Monócito (LMR), Índice de Resposta à Inflamação Sistêmica (SIRI), Índice Agregado de Inflamação Sistêmica (AISI) e Índice de Inflamação Imune Sistêmica (SII). Métodos: Determinamos índices em 52 pacientes pediátricos com DRC e 33 controles saudáveis por cálculo matemático. Pacientes com DRC foram separados em cinco grupos conforme etiologia e estadiamento: Grupo IA: glomerulopatias em estágio 1 ou 2; IB: glomerulopatias em estágio 3 ou 4; IIA: CAKUT em estágio 1 ou 2; IIB: CAKUT em estágio 3 ou 4; e III: estágios 3 ou 4 de outras etiologias. Além disso, combinamos todos os pacientes com DRC em um grupo (IV). Grupo V foi um grupo controle saudável. Resultados: Observamos valores menores de LMR nos grupos IB e IIB comparados ao grupo V (p=0,047; p=0,031, respectivamente). Encontramos valores maiores de SIRI para o grupo III versus grupo V (p=0,030). Não houve diferença para outros índices quando os grupos foram comparados dois a dois. Conclusão: Os índices LMR e SIRI apresentaram resultados promissores na avaliação da inflamação, pois correlacionaram-se com as etiologias da DRC e, principalmente, com o estadiamento desses pacientes.

show abstract

Prospective cohort analyzing risk factors for chronic kidney disease progression in children

Cited by 9 publications

References 25 publications

Management of Hypertension in CAKUT: Protective Factor for CKD

Management of Hypertension in CAKUT: Protective Factor for CKD

Pediatric chronic kidney disease: blood cell count indexes as inflammation markers

Doença renal crônica pediátrica: índices de contagem de células sanguíneas como marcadores de inflamação

Contact Info

Product

Resources

About