Objective: To analyse the timing of end stage renal disease in children with chronic kidney disease (CKD). Design: A population-based cohort study. Setting: A nationwide registry (ItalKid Project) collecting information on all patients with CKD aged <20 years. Patients: 935 children with CKD secondary to renal hypodysplasia with or without urologic malformation. In a subgroup of patients (n=40) detailed pubertal staging was analysed in relation to CKD progression. Main outcome measures: Kidney survival (KS) was estimated using renal replacement therapy (RRT) as the end-point. Puberty was staged by identifying the pubertal growth spurt. Results: A non-linear decline in the probability of KS was observed, with a steep decrease during puberty: the probability of RRT was estimated to be 9.4% and 51.8% during the first and second decades of life, respectively. A break-point in the KS curve was identified at 11.6 and 10.9 years of age in male and female patients, respectively. Conclusions: The present analysis suggests that puberty is associated with increased deterioration of renal function in CKD. The mechanism(s) underlying this unique and specific (to children) pattern of progression have not yet been identified, but it may be that sex hormones play a role in this puberty-related progression of CKD.

Puberty is associated with increased deterioration of renal function in patients with CKD : data from the ItalKid Project / G. Ardissino, S. Testa, V. Daccò, F. Paglialonga, S. Viganò, C. Felice-Civitillo, F. Battaglino, A. Bettinelli, A. Bordugo, V. Cecchetti, S. De Pascale, A. La Manna, S. Li Volti, S. Maringhini, G. Montini, M. Pennesi, L. Peratoner. - In: ARCHIVES OF DISEASE IN CHILDHOOD. - ISSN 0003-9888. - 97:10(2012 Oct), pp. 885-888.

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

G. Ardissino;G. Montini;
2012-10

Abstract

Objective: To analyse the timing of end stage renal disease in children with chronic kidney disease (CKD). Design: A population-based cohort study. Setting: A nationwide registry (ItalKid Project) collecting information on all patients with CKD aged <20 years. Patients: 935 children with CKD secondary to renal hypodysplasia with or without urologic malformation. In a subgroup of patients (n=40) detailed pubertal staging was analysed in relation to CKD progression. Main outcome measures: Kidney survival (KS) was estimated using renal replacement therapy (RRT) as the end-point. Puberty was staged by identifying the pubertal growth spurt. Results: A non-linear decline in the probability of KS was observed, with a steep decrease during puberty: the probability of RRT was estimated to be 9.4% and 51.8% during the first and second decades of life, respectively. A break-point in the KS curve was identified at 11.6 and 10.9 years of age in male and female patients, respectively. Conclusions: The present analysis suggests that puberty is associated with increased deterioration of renal function in CKD. The mechanism(s) underlying this unique and specific (to children) pattern of progression have not yet been identified, but it may be that sex hormones play a role in this puberty-related progression of CKD.
Adolescent; Child; Child, Preschool; Cohort Studies; Female; Gonadal Steroid Hormones; Humans; Infant; Kidney; Male; Puberty; Renal Insufficiency, Chronic; Renal Replacement Therapy; Sex Factors; Young Adult; Pediatrics, Perinatology and Child Health
Settore MED/38 - Pediatria Generale e Specialistica
Article (author)
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/410977
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 32
  • ???jsp.display-item.citation.isi??? 24
social impact