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Epidemiology of pediatric chronic kidney disease/kidney failure: learning from registries and cohort studies

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Abstract

Although the concept of chronic kidney disease (CKD) in children is similar to that in adults, pediatric CKD has some peculiarities, and there is less evidence and many factors that are not clearly understood. The past decade has witnessed several additional registry and cohort studies of pediatric CKD and kidney failure. The most common underlying disease in pediatric CKD and kidney failure is congenital anomalies of the kidney and urinary tract (CAKUT), which is one of the major characteristics of CKD in children. The incidence/prevalence of CKD in children varies worldwide. Hypertension and proteinuria are independent risk factors for CKD progression; other factors that may affect CKD progression are primary disease, age, sex, racial/genetic factors, urological problems, low birth weight, and social background. Many studies based on registry data revealed that the risk factors for mortality among children with kidney failure who are receiving kidney replacement therapy are younger age, female sex, non-White race, non-CAKUT etiologies, anemia, hypoalbuminemia, and high estimated glomerular filtration rate at dialysis initiation. The evidence has contributed to clinical practice. The results of these registry-based studies are expected to lead to new improvements in pediatric CKD care.

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Acknowledgements

We are grateful to Dr. Masataka Honda (Tokyo Metropolitan Children’s Medical Center, Tokyo) and Dr. Osamu Uemura (Aichi Children’s Health and Medical Center and Ichinomiya Medical Treatment & Habilitation Center, Aichi) for helpful discussions of pediatric CKD and kidney failure; Dr. Motoshi Hattori (Tokyo Women’s Medical University, Tokyo) and Dr. Seiichiro Shishido (Toho University Faculty of Medicine, Tokyo) for the help given by data of pediatric dialysis and transplantation; Dr. Hiroshi Hataya (Tokyo Metropolitan Children’s Medical Center, Tokyo) for offering advice on pediatric dialysis; and Dr. Marciana Laster (David Geffen School of Medicine at UCLA, Los Angeles, CA) for offering advice on pediatric kidney failure management during this decade in the United States. We thank Hugh McGonigle, from Edanz Group (https://en-author-services.edanz.com/ac), for editing a draft of the manuscript.

Funding

This work was funded by childhood-onset, rare and intractable kidney diseases, research on rare and intractable diseases, Health, Labour and Welfare Sciences Research Grants in Japan (20FC1028).

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  1. Department of Nephrology, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan

    Ryoko Harada & Riku Hamada

  2. Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan

    Yuko Hamasaki

  3. Department of Pediatrics, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Yusuke Okuda & Kenji Ishikura

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Correspondence to Kenji Ishikura.

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K. Ishikura has received grants from Asahi Kasei Pharma Corporation; Chugai Pharmaceutical Co., Ltd.; Novartis International AG; Zenyaku Kogyo Co., Ltd.; Japan Blood Products Organization; Otsuka Pharmaceutical Co. Ltd.; Teijin Pharma Limited; Shionogi Co., Ltd.; Eisai Co., Ltd.; Astellas Pharma Inc.; and JCR Pharmaceuticals Co., Ltd. and lecture fees from Asahi Kasei Pharma Corporation; Chugai Pharmaceutical Co., Ltd.; Novartis International AG; Zenyaku Kogyo Co. Ltd.; Otsuka Pharmaceutical Co. Ltd.; Alexion Pharmaceuticals Inc.; and Pfizer Inc. and consultant fees from Alexion Pharmaceuticals Inc. and Vifor Pharma Management Ltd. Y. Hamasaki belongs to a department endowed with sponsorship from Asahi Kasei Pharma Corporation, Novartis Pharma K.K., Chugai Pharmaceutical Co., and Astellas Pharma until 28 February 2018. Y. Hamasaki has received lecture fees and travel fees from Chugai Pharmaceutical Co., Novartis International AG, Alexion Pharmaceuticals Inc., and Pfizer Inc. R. Hamada has received grants from Chugai Pharmaceutical Co., Ltd.; Kyowa Kirin Co., Ltd.; Takeda Pharmaceutical Co., Ltd.; and Teijin Pharma Ltd. and lecture fees from Alexion Pharmaceuticals, Inc.; Asahi Kasei Pharma Corporation; Teijin Pharma Ltd.; and Chugai Pharmaceutical Co., Ltd.

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Harada, R., Hamasaki, Y., Okuda, Y. et al. Epidemiology of pediatric chronic kidney disease/kidney failure: learning from registries and cohort studies. Pediatr Nephrol 37, 1215–1229 (2022). https://doi.org/10.1007/s00467-021-05145-1

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