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)
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Special Emphasis Panel (ZDK1-GRB-8 (M1))
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Moxey-Mims, Marva M
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Children's Hospital of Philadelphia
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Greenberg, Jason H; Kakajiwala, Aadil; Parikh, Chirag R et al. (2018) Emerging biomarkers of chronic kidney disease in children. Pediatr Nephrol 33:925-933
Ng, Derek K; Schwartz, George J; Schneider, Michael F et al. (2018) Combination of pediatric and adult formulas yield valid glomerular filtration rate estimates in young adults with a history of pediatric chronic kidney disease. Kidney Int 94:170-177
Matsuda-Abedini, Mina; Fitzpatrick, Kevin; Harrell, Waverly R et al. (2018) Brain abnormalities in children and adolescents with chronic kidney disease. Pediatr Res 84:387-392
Ku, Elaine; McCulloch, Charles E; Warady, Bradley A et al. (2018) Twenty-Four-Hour Ambulatory Blood Pressure versus Clinic Blood Pressure Measurements and Risk of Adverse Outcomes in Children with CKD. Clin J Am Soc Nephrol 13:422-428
Mitsnefes, Mark M; Betoko, Aisha; Schneider, Michael F et al. (2018) FGF23 and Left Ventricular Hypertrophy in Children with CKD. Clin J Am Soc Nephrol 13:45-52
Furth, Susan L; Pierce, Chris; Hui, Wun Fung et al. (2018) Estimating Time to ESRD in Children With CKD. Am J Kidney Dis 71:783-792
Richardson, Kelsey L; Weiss, Noel S; Halbach, Susan (2018) Chronic School Absenteeism of Children with Chronic Kidney Disease. J Pediatr 199:267-271
Sgambat, Kristen; Roem, Jennifer; Mitsnefes, Mark et al. (2018) Waist-to-height ratio, body mass index, and cardiovascular risk profile in children with chronic kidney disease. Pediatr Nephrol :
Barletta, Gina-Marie; Pierce, Christopher; Mitsnefes, Mark et al. (2018) Is Blood Pressure Improving in Children With Chronic Kidney Disease? A Period Analysis. Hypertension 71:444-450
Atkinson, Meredith A; Xiao, Rui; Köttgen, Anna et al. (2018) Genetic associations of hemoglobin in children with chronic kidney disease in the PediGFR Consortium. Pediatr Res :

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