Puberty is associated with increased deterioration of renal function in patients with CKD: data from the ItalKid Project

Ardissino, Gianluigi; Testa, Sara; Daccò, Valeria; Paglialonga, Fabio; Viganò, Sara; Felice-Civitillo, Cristina; Battaglino, F; Bettinelli, Alberto; Bordugo, Andrea; Cecchetti, Valeria; Pascale, Salvatore De; Manna, Angela La; Volti, S. Li; Maringhini, Silvio; Montini, Giovanni; Pennesi, Marco; Peratoner, L.

doi:10.1136/archdischild-2011-300685

Cited by 62 publications

(34 citation statements)

References 26 publications

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“…Analysis of the paired differences in percent GFR decline showed no significant differences between the subjects with ARPKD and either control group (data not shown). Because baseline GFR and puberty/older age have been associated with more rapid decline in renal function, 18,19 we performed subanalyses to examine the impact of these two factors on GFR decline. Subjects with ARPKD and control subjects were stratified into two baseline GFR groups: GFR <45 or ≥45 ml/min/1.73m 2 and two age groups: <10 vs. ≥10 years of age.…”

Section: Resultsmentioning

confidence: 99%

Kidney Disease Progression in Autosomal Recessive Polycystic Kidney Disease

Dell

Matheson

Hartung

et al. 2016

The Journal of Pediatrics

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Objective To define glomerular filtration rate (GFR) decline, hypertension (HTN) and proteinuria in subjects with autosomal recessive polycystic kidney disease (ARPKD) and compare with two congenital kidney disease control groups in the Chronic Kidney Disease in Children (CKiD) cohort. Study design GFR decline (iohexol clearance), rates of HTN (ambulatory/casual blood pressures (BPs)), antihypertensive medication usage, left ventricular hypertrophy (LVH) and proteinuria were analyzed in subjects with ARPKD (n=22) and two control groups: aplastic/hypoplastic/dysplastic (n=44) and obstructive uropathies (n=44). Differences between study groups were examined by Wilcoxon rank sum test. Results Annualized GFR change in subjects with ARPKD was −1.4 ml/min/1.73m2 (−6%), with higher decline in subjects age >10 years (−11.5%). However, overall rates of GFR decline did not differ significantly in subjects with ARPKD vs. controls. There were no significant differences in HTN or LVH rates, but subjects with ARPKD had a higher percent on ≥3 BP medications (32% vs.0%, p<0.0001), more ACE inhibitor use (82% vs. 27% vs. 36%, p<0.0005), and less proteinuria (urine protein: creatinine=0.1 vs.0.6, p<0.005). Conclusions This study reports rates of GFR decline, HTN and proteinuria in a small but well-phenotyped ARPKD cohort. The relatively slow rate of GFR decline in subjects with ARPKD and absence of significant proteinuria suggest that these standard clinical measures may have limited utility in assessing therapeutic interventions and highlight the need for other ARPKD kidney disease progression biomarkers.

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Section: Resultsmentioning

confidence: 99%

Kidney Disease Progression in Autosomal Recessive Polycystic Kidney Disease

Dell

Matheson

Hartung

et al. 2016

The Journal of Pediatrics

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“…Data from the ItalKid Project [32] showed that the probability of RRT was 9.4% during the first decade of life and 51.8% during the second decade. There was a clear break point at puberty in the kidney survival curve, with an ensuing decline after puberty in both males and females.…”

Section: Factors Affecting Progression Of Ckdmentioning

confidence: 99%

A Review of Pediatric Chronic Kidney Disease

Kaspar

Bholah²,

Bunchman³

2016

Blood Purif

114

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“…Loss of renal function with progression through adolescence is well demonstrated and not solely explained by noncompliance of teenagers. The ItalKid study authors suggested that the possible mechanisms for this fi nding are: (1) imbalance between glomerular capacity and increased body mass, or (2) an effect related to the changing sex hormone environment with progression [ 47 ]. In addition, adolescence and young adulthood also represent a time of sexual growth and experimentation, and for young men with PUV, erectile dysfunction, ejaculatory issues, and fertility are of paramount concern.…”

Section: Follow-upmentioning

confidence: 97%