Early predictive factors for progression to kidney failure in infants with severe congenital anomalies of the kidney and urinary tract View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2022-08-11

AUTHORS

Kentaro Nishi, Osamu Uemura, Ryoko Harada, Masaki Yamamoto, Yusuke Okuda, Kenichiro Miura, Yoshimitsu Gotoh, Tomoo Kise, Daishi Hirano, Yuko Hamasaki, Naoya Fujita, Toru Uchimura, Takeshi Ninchoji, Tetsuya Isayama, Riku Hamada, Koichi Kamei, Tetsuji Kaneko, Kenji Ishikura

ABSTRACT

BackgroundSevere congenital anomalies of the kidney and urinary tract (CAKUT) progress to infantile kidney failure with replacement therapy (KFRT). Although prompt and precise prediction of kidney outcomes is important, early predictive factors for its progression remain incompletely defined.MethodsThis retrospective cohort study included patients with CAKUT treated at 12 centers between 2009 and 2020. Patients with a maximum serum creatinine level ≤ 1.0 mg/dL during the first 3 days, patients who died of respiratory failure during the neonatal period, patients who progressed to KFRT within the first 3 days, and patients lacking sufficient data were excluded.ResultsOf 2187 patients with CAKUT, 92 were finally analyzed. Twenty-five patients (27%) progressed to KFRT and 24 (26%) had stage 3–5 chronic kidney disease without replacement therapy during the median observation period of 52.0 (interquartile range, 22.0–87.8) months. Among these, 22 (24%) progressed to infantile KFRT. The kidney survival rate during the infantile period was significantly lower in patients with a maximum serum creatinine level during the first 3 days (Cr-day3-max) ≥ 2.5 mg/dL (21.8%) compared with those with a Cr-day3-max < 2.5 mg/dL (95.2%) (log-rank, P < 0.001). Multivariate analysis demonstrated Cr-day3-max (P < 0.001) and oligohydramnios (P = 0.025) were associated with higher risk of infantile KFRT. Eighty-two patients (89%) were alive at the last follow-up.ConclusionsNeonatal kidney function, including Cr-day3-max, was associated with kidney outcomes in patients with severe CAKUT. Aggressive therapy for severe CAKUT may have good long-term life outcomes through infantile dialysis and kidney transplantation.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information More... »

PAGES

1-10

Journal

TITLE

Pediatric Nephrology

ISSUE

N/A

VOLUME

N/A

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-022-05703-1

DOI

http://dx.doi.org/10.1007/s00467-022-05703-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1150157264

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35951131


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13 schema:description BackgroundSevere congenital anomalies of the kidney and urinary tract (CAKUT) progress to infantile kidney failure with replacement therapy (KFRT). Although prompt and precise prediction of kidney outcomes is important, early predictive factors for its progression remain incompletely defined.MethodsThis retrospective cohort study included patients with CAKUT treated at 12 centers between 2009 and 2020. Patients with a maximum serum creatinine level ≤ 1.0 mg/dL during the first 3 days, patients who died of respiratory failure during the neonatal period, patients who progressed to KFRT within the first 3 days, and patients lacking sufficient data were excluded.ResultsOf 2187 patients with CAKUT, 92 were finally analyzed. Twenty-five patients (27%) progressed to KFRT and 24 (26%) had stage 3–5 chronic kidney disease without replacement therapy during the median observation period of 52.0 (interquartile range, 22.0–87.8) months. Among these, 22 (24%) progressed to infantile KFRT. The kidney survival rate during the infantile period was significantly lower in patients with a maximum serum creatinine level during the first 3 days (Cr-day3-max) ≥ 2.5 mg/dL (21.8%) compared with those with a Cr-day3-max < 2.5 mg/dL (95.2%) (log-rank, P < 0.001). Multivariate analysis demonstrated Cr-day3-max (P < 0.001) and oligohydramnios (P = 0.025) were associated with higher risk of infantile KFRT. Eighty-two patients (89%) were alive at the last follow-up.ConclusionsNeonatal kidney function, including Cr-day3-max, was associated with kidney outcomes in patients with severe CAKUT. Aggressive therapy for severe CAKUT may have good long-term life outcomes through infantile dialysis and kidney transplantation.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information
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17 schema:keywords Abstract
18 CAKUT
19 Graphical Abstract
20 Graphical abstractA higher resolution version
21 KFRT
22 MethodsThis retrospective cohort study
23 aggressive therapy
24 analysis
25 anomalies
26 center
27 chronic kidney disease
28 cohort study
29 congenital anomalies
30 creatinine levels
31 data
32 days
33 dialysis
34 disease
35 early predictive factors
36 factors
37 failure
38 function
39 high risk
40 high-resolution version
41 infantile period
42 infants
43 information
44 kidney
45 kidney disease
46 kidney failure
47 kidney function
48 kidney outcomes
49 kidney survival rates
50 kidney transplantation
51 levels
52 life outcomes
53 long-term life outcomes
54 max
55 maximum serum creatinine level
56 median observation period
57 months
58 multivariate analysis
59 neonatal period
60 observation period
61 oligohydramnios
62 outcomes
63 patients
64 period
65 precise prediction
66 prediction
67 predictive factors
68 progress
69 progression
70 rate
71 replacement therapy
72 resolution version
73 respiratory failure
74 retrospective cohort study
75 risk
76 serum creatinine levels
77 severe CAKUT
78 severe congenital anomalies
79 stage 3
80 study
81 sufficient data
82 supplementary information
83 survival rate
84 therapy
85 tract
86 transplantation
87 urinary tract
88 version
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