Pediatric CKD rates increase substantially in south of England

By Helen Albert, Senior medwireNews Reporter

Research shows that the number of children with moderate-to-severe (stages 3-5) chronic kidney disease (CKD) in the south of England rose significantly between 2005 and 2009.

"Our findings have major implications for provision of healthcare services for children with CKD in the UK," write Manish Sinha (Guys & St Thomas' NHS Foundation Trust, London) and colleagues in the Archives of Disease in Childhood.

However, the team suggests that due to improved management of this condition in recent years, "the majority of children with CKD will proceed to kidney transplantation, transition to adult nephrology services, and continue to require lifelong medical care."

The team assessed data collected on all children with CKD stages 3-5 (estimated glomerular filtration rate below 60 mL/min/1.73 m²) managed at the Evelina Children's Hospital in London, which deals with all children with this condition in South London and a large section of South East England, between 2005 and 2009.

In total, 293 children were diagnosed and treated during this time. The median age of the children was 6.7 years, with 288 aged younger than 16 years and five aged 16-18 years at diagnosis.

The researchers found that the incidence and prevalence of CKD stages 3-5 increased significantly between 2005 and 2009, from a respective 8.4 and 79.5 per million age-related population (pmarp) in 2005 to 25.2 and 104.7 pmarp, respectively, in 2009.

A significant proportion (34%) of the 141 children who were diagnosed with incident CKD over the observation period were below the age of 2 years and had congenital renal disease and 23% were aged 12.0-15.9 years and had glomerulonephritides.

During 2005-2009, 45 (15%) of the children with CKD stages 3-5 had kidney transplants and 22 (8%) were transferred to adult care. Overall, seven children died, resulting in a death rate of 0.84 per 100 patient years.

"Owing to the low death rate, the majority of children with CKD will proceed to receive kidney transplantation as children or will be transitioned to adult nephrology services for lifelong medical care," say Sinha and co-authors.

"These issues have important implications for future research and healthcare provision planning and funding," they conclude.

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