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Prospective cohort analyzing risk factors for chronic kidney disease progression in children.
Belangero, Vera M S; Prates, Liliane C; Watanabe, Andreia; Schvartsman, Benita S G; Nussenzveig, Paula; Cruz, Natalia A; Abreu, Ana L S; Paz, Isabel P; Facincani, Inalda; Morgantetti, Fernanda E C; Silva, Andreia O; Andrade, Olberes V B; Camargo, Maria F C; Nogueira, Paulo C Koch.
Afiliação
  • Belangero VMS; Universidade Estadual de Campinas (UNICAMP), Nefrologia Pediátrica, Campinas, SP, Brazil.
  • Prates LC; Universidade Estadual de Campinas (UNICAMP), Nefrologia Pediátrica, Campinas, SP, Brazil.
  • Watanabe A; Instituto da Criança, Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Schvartsman BSG; Instituto da Criança, Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Nussenzveig P; Hospital Infantil Darcy Vargas, Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Cruz NA; Hospital Infantil Darcy Vargas, Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Abreu ALS; Universidade Federal de São Paulo (UNIFESP), Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Paz IP; Universidade Federal de São Paulo (UNIFESP), Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Facincani I; Universidade de São Paulo (USP), Nefrologia Pediátrica, Ribeirão Preto, SP, Brazil.
  • Morgantetti FEC; Universidade de São Paulo (USP), Nefrologia Pediátrica, Ribeirão Preto, SP, Brazil.
  • Silva AO; Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Andrade OVB; Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Camargo MFC; Hospital Samaritano de São Paulo, Nefrologia Pediátrica, São Paulo, SP, Brazil.
  • Nogueira PCK; Universidade Federal de São Paulo (UNIFESP), Nefrologia Pediátrica, São Paulo, SP, Brazil; Hospital Samaritano de São Paulo, Nefrologia Pediátrica, São Paulo, SP, Brazil. Electronic address: pckochnogueira@gmail.com.
J Pediatr (Rio J) ; 94(5): 525-531, 2018.
Article em En | MEDLINE | ID: mdl-28982638
OBJECTIVE: To identify risk factors for chronic kidney disease progression in Brazilian children and to evaluate the interactions between factors. METHODS: This was a multicenter prospective cohort in São Paulo, involving 209 children with CKD stages 3-4. The study outcome included: (a) death, (b) start of kidney replacement therapy, (c) eGFR decrease >50% during the followup. Thirteen risk factors were tested using univariate regression models, followed by multivariable Cox regression models. The terms of interaction between the variables showing significant association with the outcome were then introduced to the model. RESULTS: After a median follow-up of 2.5 years (IQR=1.4-3.0), the outcome occurred in 44 cases (21%): 22 started dialysis, 12 had >50% eGFR decrease, seven underwent transplantation, and three died. Advanced CKD stage at onset (HR=2.16, CI=1.14-4.09), nephrotic proteinuria (HR=2.89, CI=1.49-5.62), age (HR=1.10, CI=1.01-1.17), systolic blood pressure Z score (HR=1.36, CI=1.08-1.70), and anemia (HR=2.60, CI=1.41-4.77) were associated with the outcome. An interaction between anemia and nephrotic proteinuria at V1 (HR=0.25, CI=0.06-1.00) was detected. CONCLUSIONS: As the first CKD cohort in the southern hemisphere, this study supports the main factors reported in developed countries with regards to CKD progression, affirming the potential role of treatments to slow CKD evolution. The detected interaction suggests that anemia may be more deleterious for CKD progression in patients without proteinuria and should be further studied.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Progressão da Doença / Insuficiência Renal Crônica Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr (Rio J) Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Progressão da Doença / Insuficiência Renal Crônica Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: J Pediatr (Rio J) Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil