Ultrasound-Based Renal Parenchymal Area and Kidney Function Decline in Infants With Congenital Anomalies of the Kidney and Urinary Tract.

Document Type

Article

Publication Date

9-2021

Identifier

DOI: 10.1016/j.semnephrol.2021.09.004; PMCID: PMC9036416

Abstract

Congenital anomalies of the kidney and urinary tract are the leading cause of chronic kidney disease in children. Noninvasive imaging biomarkers that predict chronic kidney disease progression in early infancy are needed. We performed a pilot study nested in the prospective Chronic Kidney Disease in Children cohort study to determine the association between renal parenchymal area (RPA) on first post-natal renal ultrasound and change in estimated glomerular filtration rate (eGFR) in children with congenital anomalies of the kidney and urinary tract. Among 14 participants, 78.6% were males, the median age at the time of the ultrasound was 3.4 months (interquartile range, 1.3-7.9 mo), and the median total RPA z-score at baseline was -1.01 (interquartile range, -2.39 to 0.52). After a median follow-up period of 7.4 years (interquartile range, 6.8-8.2 y), the eGFR decreased from a median of 49.4 mL/min per 1.73 m2 at baseline to 29.4 mL/min per 1.73 m2, an annual eGFR percentage decrease of -4.68%. Lower RPA z-scores were correlated weakly with a higher annual decrease in eGFR (Spearman correlation, 0.35; 95% confidence interval, -0.25 to 0.76). This pilot study shows the feasibility of obtaining RPA from a routine ultrasound and suggests that a lower baseline RPA may be associated with a greater decrease in eGFR over time. Further studies with larger patient cohorts are needed to confirm this association.

Journal Title

Seminars in nephrology

Volume

41

Issue

5

First Page

427

Last Page

433

MeSH Keywords

Child; Cohort Studies; Disease Progression; Glomerular Filtration Rate; Humans; Infant; Kidney; Male; Pilot Projects; Prospective Studies; Renal Insufficiency, Chronic; Risk Factors; Urinary Tract

PubMed ID

34916003

Keywords

CKD; children; congenital anomalies; kidney; renal parenchymal area; urinary tract

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