Poor growth, delayed puberty and heart problems plague kids with mild kidney disease

Heart disease causes almost 35% of deaths in young adults with chronic kidney disease. What factors during childhood might contribute, and how serious do kidney problems have to be before they trigger damage to the heart? To find out, Susan Furth, MD, PhD, of the Children's Hospital of Philadelphia and her colleagues studied 586 children with chronic kidney disease.

Among the major findings:

• Poor growth, delayed puberty, metabolic problems (such as pH and electrolyte imbalances), and high blood pressure often occurred in children with only mildly or moderately impaired kidneys.
• Even when children took medications to treat some of these conditions, they were more common as kidney function decreased.

"We were hoping to identify risk factors for CKD progression and see if these can be targeted to slow the decline of kidney function and prevent its complications," said Dr. Furth. "Our findings suggest that more aggressive interventions to improve blood pressure and metabolic abnormalities may be areas where interventions could slow chronic kidney disease progression and decrease the prevalence of cardiovascular disease in children and young adults with chronic kidney disease. The next step will be to design clinical trials of these interventions based on our findings."

Study co-authors include Alison Abraham, PhD, Judith Jerry-Fluker (Johns Hopkins Bloomberg School of Public Health; George Schwartz, MD (University of Rochester Medical Center); Mark Benfield, MD (Pediatric Nephrology of Alabama); Frederick Kaskel, MD, PhD (Albert Einstein Yeshiva University); Craig Wong, MD (University of New Mexico, Albuquerque); Robert Mak, MD, PhD (University of California at San Diego); Marva Moxey-Mims, MD (National Institutes of Health); and Bradley Warady, MD (University of Missouri-Kansas City School of Medicine).