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• W2093754865 abstract "You have accessJournal of UrologyPediatrics: Congenital Anomalies - Kidney & Ureter1 Apr 2010449 CHILDREN WITH UROLOGICAL DISORDERS IN THE CHRONIC KIDNEY DISEASE IN CHILDREN (CKID) COHORT: CLINICAL CHARACTERISTICS AND ESTIMATION OF GFR Jennifer Dodson, Judith Jerry-Fluker, Derek Ng, Bradley Warady, and Susan Furth Jennifer DodsonJennifer Dodson Baltimore, MD More articles by this author , Judith Jerry-FlukerJudith Jerry-Fluker Baltimore, MD More articles by this author , Derek NgDerek Ng Baltimore, MD More articles by this author , Bradley WaradyBradley Warady Kansas City, MO More articles by this author , and Susan FurthSusan Furth Baltimore, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.521AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Structural urological disease is the most common cause of pediatric chronic kidney disease. We assessed the accuracy of formulas to estimate level of kidney function in children with urological disorders in the CKiD cohort. METHODS The CKiD study is a prospective, observational cohort of children recruited from 47 sites in the US and Canada. Eligibility requirements include age 1 to 16 yr and estimated glomerular filtration rate (GFR) via Schwartz formula (kHt(cm)/Scr) 30 to 90 ml/min/1.73 m2. Baseline demographics, clinical variables, GFR, and physical examination were assessed at study entry. A cross-sectional analysis of children was performed using non-parametric methods for continuous variables and Fisher's exact test for categorical variables. We compared estimated to measured GFR using linear regression. RESULTS 575 participants had ≥1 measure of GFR and 60% had an underlying urological diagnosis: obstructive uropathy (n=116), aplastic/hypoplastic/dysplastic kidneys (n=103), reflux nephropathy (n=86), prune belly (n=11), and other (n=27). Among these, the median age was 9yrs and duration of CKD 7yrs. 85% (n=287) had seen a urologist at median age <1yr, and 70% (n=234) had undergone a urological procedure. Most diagnoses were by ultrasound (97%) and VCUG (74%). Compared to children with other causes of kidney disease, those with underlying urological disorders were predominantly male (67% vs. 54%, p<0.01), Caucasian (68% vs. 65%, p=0.05), younger at onset of kidney disease (<1 vs. 5 years, p<0.01), premature (15% vs. 11 %, p=0.05), low birth weight (21% vs 16%, p=0.03), and in a lower weight percentile (39th vs. 54th, <0.01). Mean GFR measured by iohexol plasma disappearance for children with urological disorders was 46.6 ml/min/1.73m2. Mean estimated GFR by the Schwartz formula was 64.2 (bias=37% (95% CI: 33%, 40%, p<0.001)). Mean estimated GFR by the CKiD equation (includes Cr and cystatin) was 44.8, (bias=-2.7% (95% CI: -4.7%,-1%, p=0.009). Mean estimated GFR by the Filler equation (includes cystatin C) was 42.6 (bias=-2.1% (95% CI: -5, 1.0, p=0.19). CONCLUSIONS Underlying urological causes of CKD are present in 60% of participants in the CKiD study. These children were diagnosed earlier and were more likely than other participants to have been premature, low birth weight and to have growth delay. GFR was systematically over-estimated by the Schwartz equation, while the CKiD estimating equation and the Filler equation based on cystatin C levels were more accurate in estimating GFR in this population. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e177 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jennifer Dodson Baltimore, MD More articles by this author Judith Jerry-Fluker Baltimore, MD More articles by this author Derek Ng Baltimore, MD More articles by this author Bradley Warady Kansas City, MO More articles by this author Susan Furth Baltimore, MD More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ..." @default.
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• W2093754865 title "449 CHILDREN WITH UROLOGICAL DISORDERS IN THE CHRONIC KIDNEY DISEASE IN CHILDREN (CKID) COHORT: CLINICAL CHARACTERISTICS AND ESTIMATION OF GFR" @default.
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