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New Staging System Predicts CKD Progression in Children

First tool to aid timing of progression of chronic kidney disease to end-stage renal disease

TUESDAY, April 10, 2018 (HealthDay News) — A new staging system can help better predict the length of time until a child with chronic kidney disease (CKD) will progress to end-stage renal disease (ESRD), according to a study published online April 10 in the American Journal of Kidney Disease.

Susan L. Furth, M.D., Ph.D., from the Children’s Hospital of Philadelphia, and colleagues estimated time to ESRD in children with CKD using baseline levels of estimated glomerular filtration rate (eGFR) and proteinuria (urine protein creatinine ratio [UPCR]) among 1,232 children (aged 1 to 18 years) participating in the North American Chronic Kidney Disease in Children study and the European Effect of Strict Blood Pressure Control and ACE Inhibition on the Progression of CRF in Pediatric Patients trial.

The researchers found that median times to event ranged from longer than 10 years (for eGFRs of 45 to 90 mL/min/1.73 m² and UPCRs < 0.5 mg/mg) to 0.8 years (for eGFRs of 15 to 30 mL/min/1.73 m² and UPCRs > 2.0 mg/mg). Compared to children with non-glomerular disease, children with glomerular disease had an estimated 43 percent shorter time to event. Risk patterns were consistent across the 10 subsample validation models.

“CKD staged by level of eGFR and proteinuria characterizes the timeline of progression and can guide management strategies in children,” the authors write.

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