Kidney Trouble Starts Early in Kids

Heart disease and metabolic risks from chronic kidney disease occur earlier in children

(RxWiki News) Many diseases act differently in children than in adults. Kidney disease is one of these. Now, recent findings may change the way kidney disease is treated in children.

Complications of kidney disease happen early in children. In light of this finding, children with kidney disease may need earlier, more aggressive treatment.

"Start treating your child's kidney disease early."

Lead author Susan Furth, M.D., Ph.D., of The Children's Hospital of Philadelphia, and colleagues conducted this study, which confirmed many experts' earlier suspicions that children with kidney disease experience complications earlier than adults.

Some of the major complications for children with kidney disease include: growth failure (when the rate of weight gain is lower than normal) metabolic abnormalities, including high phosphorous and potassium, acidosis (too much acid in the blood), anemia (not enough healthy red blood cells), and high cholesterol. 

According to Dr. Furth, these metabolic problems and heart disease risk factors have rarely been studied in children with kidney disease. She says the research team set out to find the point along the GFR (glomerular filtration rate) scale where complications of kidney disease became more common. GFR is a measure of kidney function.

Dr. Furth and colleagues found that metabolic abnormalities and heart disease risk factors happen at a GFR of 50 milliliters, an amount that represents half of normal kidney function. Even if children were treated, these complications became two-to-four times more common as GFR decreased.

This finding is important because many kids may not be diagnosed with kidney disease until kidney function is at a much lower level, explains Dr. Marva Moxey-Mims, a pediatric kidney specialist at the National Institutes of Health. This study shows that complications can start even with a GFR above 50.

Before this study, pediatric kidney experts already had a hunch that complications started earlier in children, says Dr. Moxey-Mims. Now, these experts have evidence supporting their suspicion.

The study by Dr. Furth and her fellow researchers - which is published in the September 2011 issue of the Clinical Journal of the American Society of Nephrology - is part of the Chronic Kidney Disease in Children (CKiD) Study. It is the largest multi-center, prospective study of children with chronic kidney disease. Participants are 586 children and teenagers between the ages of one and 16 years with mild to moderate impairment of kidney function (a GFR between 90 and 30).

CKiD is supported in part by the National Institute of Neurological Disorders and Stroke, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute.

Review Date: 
October 3, 2011