Development of a risk score for earlier diagnosis of chronic kidney disease in children.

PLoS One 2019 19;14(4):e0215100. Epub 2019 Apr 19.

Nephrology Division, Federal University of Sao Paulo, Sao Paulo, Brazil.

Objective: To develop a clinical score for the early identification of chronic kidney disease (CKD) in children and adolescents. The early diagnosis of CKD in childhood allows the adoption of measures to slow the progression of the disease, thereby reducing morbidity and mortality. Nevertheless, the diagnosis is often made too late for proper patient management.

Study Design: We preformed a case-control study of a multicenter Brazilian sample of 752 pediatric patients; the study cases (n = 376) were CKD patients with a median estimated GFR of 37 (IQR = 22 to 57) ml/min/1.73 m2. The control group (n = 376) comprised age-, gender- and center-matched children who were followed for nonrenal diseases. Potential risk factors were investigated through a standard questionnaire that included symptoms, medical history, and a clinical examination. Two multivariable models (A and B) were fitted to assess predictors of the diagnosis of CKD.

Results: In model A, 9 variables were associated with CKD diagnosis: antenatal ultrasound with urinary malformation, recurrent urinary tract infection, polyuria, abnormal urine stream, nocturia, growth curve flattening, history of hypertension, foamy urine and edema (c-statistic = 0.938). Model B had the same variables as model A, except for the addition of the history of admission during the neonatal period and the exclusion of antenatal ultrasound variables (c-statistic = 0.927).

Conclusions: The present scores may serve as a warning sign for CKD diagnosis in children among professionals working in the primary care setting where the symptoms associated with a risk of CKD may be overlooked.

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Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215100PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474594PMC
April 2019
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References

(Supplied by CrossRef)
Chronic Kidney Disease
AC Webster et al.
Lancet 2017
Epidemiology of pediatric chronic kidney disease
V Chadha et al.
Adv Chronic Kidney Dis 2005
Screening for CKD in children: a global controversy
RJ Hogg et al.
Clin J Am Soc Nephrol 2009
Urinary protein to creatinine ratio and urinary sediments are useful for the screening of chronic kidney disease
S Kobayashi et al.
Rinsho Byori 2009

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