Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Pediatrics, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia-Yi, Taiwan.
J Formos Med Assoc. 2019 Oct;118(10):1423-1429. doi: 10.1016/j.jfma.2018.12.016. Epub 2019 Jan 5.
BACKGROUND/PURPOSE: The aims of this study were to determine the long-term associated factors for chronic kidney disease (CKD) progression in a pediatric group with non-glomerular (non-GN) etiologies.
Pediatric patients with a presumptive diagnosis of CKD were enrolled to this study. Recorded information included demographic and laboratory information. We included the patients with non-GN etiologies and investigated the factors including systolic and diastolic blood pressure (BP), proteinuria, and anemia status in association with reductions in the estimated glomerular filtration rate (eGFR).
A total of 308 children were enrolled and the mean duration of follow-up was 4.40 ± 3.53 years. Median baseline age was 5 years old and the males represented 55% of all patients. One-unit increased baseline systolic BP z-score was associated with 1.2 ml/min per 1.73 m (95% CI = -2 to -0.5) faster rate of eGFR decline. The presence of baseline proteinuria and anemia were also associated with 4.1 ml/min per 1.73 m (95% CI = -5.7 to -2.5) and 2.2 ml/min per 1.73 m (95% CI = -3.6 to -0.8) more rapid eGFR declination, respectively. Hypertension, anemia and proteinuria during the follow-up were also associated with 3.25 ml/min per 1.73 m (95% CI = -5.32 to -1.18), 4.34 ml/min per 1.73 m (95% CI = -7.25 to -1.43) and 4.97 ml/min per 1.73 m (95% CI = -8.23 to -1.71) more rapid eGFR declination, respectively.
Elevated systolic BP, proteinuria, and anemia are independently associated with CKD progression in pediatric patients with non-GN etiologies.
背景/目的：本研究旨在确定非肾小球（非 GN）病因的儿科患者中慢性肾脏病（CKD）进展的长期相关因素。
本研究纳入了疑似 CKD 的儿科患者。记录的信息包括人口统计学和实验室信息。我们纳入了非 GN 病因的患者，并调查了与估算肾小球滤过率（eGFR）下降相关的收缩压和舒张压（BP）、蛋白尿和贫血状态等因素。
共纳入 308 名儿童，平均随访时间为 4.40 ± 3.53 年。中位基线年龄为 5 岁，男性占所有患者的 55%。基线收缩压 z 评分增加 1 个单位与 eGFR 下降速度加快 1.2 ml/min/1.73 m（95%CI=-2 至-0.5）相关。基线蛋白尿和贫血的存在也分别与 eGFR 下降速度加快 4.1 ml/min/1.73 m（95%CI=-5.7 至-2.5）和 2.2 ml/min/1.73 m（95%CI=-3.6 至-0.8）相关。随访期间的高血压、贫血和蛋白尿也与 eGFR 下降速度加快 3.25 ml/min/1.73 m（95%CI=-5.32 至-1.18）、4.34 ml/min/1.73 m（95%CI=-7.25 至-1.43）和 4.97 ml/min/1.73 m（95%CI=-8.23 至-1.71）相关。
在非 GN 病因的儿科患者中，升高的收缩压、蛋白尿和贫血与 CKD 进展独立相关。
