EHRs can be used to study large cohorts of children with CKD

Researchers efficiently used digital well being file knowledge to measure and determine threat elements of continual kidney illness development in a big cohort of pediatric sufferers, based on a speaker at ASN Kidney Week.

“Whereas landmark potential cohort research by Persistent Kidney Illness in Kids (CKiD) have been instrumental in forming the inspiration of information of CKD in youngsters, there stay important gaps in our information largely as a consequence of its rarity,” Caroline A. Gluck, MD, MTR, from Nemours Alfred I. duPont Hospital for Kids, stated. “The targets of this examine had been to make use of actual work electronic health record data to review kidney perform decline in a big cohort of youngsters and mannequin CKD development.”

In a retrospective cohort examine, researchers recognized 7,395 youngsters (median age, 14.1 years; 36% feminine; 23% had been Black) with CKD and aged 1 12 months to 18 years between 2009 and 2020 utilizing EHR knowledge from PEDSnet.

“We used a composite final result for CKD development: having eGFR lower than 15 [mL/min/1.73 m²] or requiring continual dialysis or kidney transplant,” Gluck stated.

Sufferers had been categorized into glomerular, non-glomerular and malignancy sub-cohorts and had been evaluated on the influence of hypertension (at the least two visits with hypertension code) and proteinuria (at the least one lab worth of 1+) inside 2 years of cohort entrance on development.

Among the many sufferers, 36% had proteinuria, 46% had hypertension and the median preliminary eGFR was 75.5 mL/min/1.73 m². Analyses revealed youngsters with glomerular CKD (n=5,739) had been extra more likely to attain outcomes than these with malignancies (n=565) or with out glomerular CKD (n=1,091). Equally, youngsters with hypertension, proteinuria or each had been extra more likely to attain outcomes.

“General, this examine exhibits the promise of utilizing aggregated EHR knowledge to review CKD progression in children. Our knowledge mirrors observations in CKiD that CKD etiology, proteinuria and hypertension increase the chance for CKD development,” Gluck stated. “We moreover recognized that age at cohort entry, CKD stage and pediatric medical complexity algorithm rating had been threat elements. These threat elements could assist us to focus on future comparative effectiveness trials for slowing CKD development.”

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American Society of Nephrology Annual Assembly