Acute Kidney Infection in Pediatric Chronic Kidney Disease
Embargo until
2021-05-01
Date
2020-04-28
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Johns Hopkins University
Abstract
Chronic kidney disease (CKD) is a chronic disease where the kidneys gradually lose their ability to filter wastes from the bloodstream. Acute infections, particularly kidney infections, are of interest in the pediatric CKD setting as they may have implications on disease progression due to the potential for infection-induced kidney injury, which may accelerate CKD progression. Here, we examined prevalence and incidence of, and risk factors associated with, two outcomes: kidney infection, and bladder infection/UTI, using data from the Chronic Kidney Disease in Children (CKiD) study. Altogether, we analyzed 4,667 person-visits across 955 study participants. We identified statistically significant differences in disease prevalence and incidence across both gender and diagnosis (glomerular vs. non-glomerular). For example, compared to boys with glomerular diagnoses, girls with glomerular diagnoses had 2.5 times the past-year prevalence of kidney disease, boys with glomerular diagnoses had 10.1 times greater past-year prevalence of kidney disease, and girls with glomerular diagnoses had 11.8 times greater past-year prevalence of kidney disease. For bladder infection/UTI, these prevalence ratios were 12.3, 17.2, and 24.0, respectively. In children with non-glomerular diagnoses, we identified high CRP and proteinuria as risk factors for both acute kidney infection and acute bladder infection/UTI, low household income as a risk factor for acute bladder infection/UTI, and interestingly, hypertension as a risk factor for bladder infection/UTI. In children with glomerular diagnoses, we identified corticosteroid therapy as a risk factor for kidney infection.
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Keywords
CKD, chronic kidney disease, kidney infection, pediatric CKD, bladder infection. UTI