Chronic kidney disease (CKD) and its metabolic derangements substantially affect the well-being of children. In order to define the nature, magnitude, and temporal evolution of the adverse effects of progressive CKD, we propose to conduct a prospective study of CKD in children to determine (1) risk factors for accelerated decline in renal function;(2) incidence, nature, magnitude and temporal evolution of impaired brain function and structure;(3) prevalence of risk factors for cardiovascular disease (CVD);and (4) implications of growth failure and its treatment on morbidity. ]'he Prospective Study of Chronic Kidney Disease in Children (C-Kid) is a longitudinal, observational study of 600 children, aged <19 yrs with mildly to moderately impaired kidney function (estimated glomerular filtration rate (GFR) 30-75 ml/min/1.73m2). The follow-up period will be 2.5 to 4.5 years. At enrollment, and at annual visits thereafter, selected exposures will be obtained on participants, including sociodemographic characteristics, family history, health care utilization, environmental exposures and medication use using standardized questionnaires. Standardized blood pressure, growth and nutritional assessments, metabolic status, measures of anemia, dyslipidemia, measures of microinflammation, insulin resistance and proteinuria will also be measured. Level of kidney function (GFR) will be measured annually by plasma disappearance of iohexol. The primary outcomes of interest will be the temporal evolution of subclinical measures and clinical events associated with CKD progression as measured by decline in GFR, growth failure and its treatment, neurocognitive and behavioral deficits and cardiovascular disease, specified in our aims below. Potential analyses that could be conducted using the C-Kid infrastructure to explore risk-factor disease relationships include traditional prospective cohort analyses where putative risk factors are measured in participants at baseline;nested case-control studies in which laboratory studies are performed on stored baseline specimens in cases (e.g. rapid progressors) and appropriately matched controls (e.g. non-progressors);and cross-cohort analyses utilizing parallel cohorts.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZDK1-GRB-8 (M1))
Program Officer
Moxey-Mims, Marva M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Children's Hospital of Philadelphia
United States
Zip Code
Mendley, Susan R; Matheson, Matthew B; Shinnar, Shlomo et al. (2015) Duration of chronic kidney disease reduces attention and executive function in pediatric patients. Kidney Int 87:800-6
Deng, Fang; Finer, Gal; Haymond, Shannon et al. (2015) Applicability of estimating glomerular filtration rate equations in pediatric patients: comparison with a measured glomerular filtration rate by iohexol clearance. Transl Res 165:437-45
Hartung, Erum A; Matheson, Matthew; Lande, Marc B et al. (2014) Neurocognition in children with autosomal recessive polycystic kidney disease in the CKiD cohort study. Pediatr Nephrol 29:1957-65
Kupferman, Juan C; Aronson Friedman, Lisa; Cox, Christopher et al. (2014) BP control and left ventricular hypertrophy regression in children with CKD. J Am Soc Nephrol 25:167-74
Barletta, Gina-Marie; Flynn, Joseph; Mitsnefes, Mark et al. (2014) Heart rate and blood pressure variability in children with chronic kidney disease: a report from the CKiD study. Pediatr Nephrol 29:1059-65
Portale, Anthony A; Wolf, Myles; Juppner, Harald et al. (2014) Disordered FGF23 and mineral metabolism in children with CKD. Clin J Am Soc Nephrol 9:344-53
Akchurin, Oleh M; Schneider, Michael F; Mulqueen, Lucy et al. (2014) Medication adherence and growth in children with CKD. Clin J Am Soc Nephrol 9:1519-25
Abraham, Alison G; Mak, Robert H; Mitsnefes, Mark et al. (2014) Protein energy wasting in children with chronic kidney disease. Pediatr Nephrol 29:1231-8
Zhong, Yichen; Muñoz, Alvaro; Schwartz, George J et al. (2014) Nonlinear trajectory of GFR in children before RRT. J Am Soc Nephrol 25:913-7
Rodig, Nancy M; McDermott, Kelly C; Schneider, Michael F et al. (2014) Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study. Pediatr Nephrol 29:1987-95

Showing the most recent 10 out of 70 publications