Trajectories of Kidney Function in Children with Reduced Kidney Function

Abstract

Little is known about the progression of chronic kidney disease (CKD) during the emerging adulthood period in patients with pediatric onset CKD cared for in primary care. We performed a retrospective cohort study using administrative data from The Health Improvement Network Database to determine the natural history of CKD, the impact of the emerging adulthood period, and the effects of comorbidities including mental health disorders, substance use, and pregnancy on CKD progression. We identified 15,679 patients who met cohort inclusion criteria. We found that kidney function measured using the estimated glomerular filtration rate (eGFR) increased with increasing age. Emerging adulthood was associated with an attenuation in this increase in eGFR. Finally, the presence of mental health disorders, substance use, and pregnancy modified the relationship between age and eGFR resulting in a small, but statistically significant acceleration in the eGFR increase over age, but were associated with lower baseline eGFR.