Study identifies risk factors for advanced CKD in adults with cerebral palsy
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Researchers from the University of Michigan have identified several medical conditions that may increase the likelihood of adults with cerebral palsy developing advanced chronic kidney disease.
According to Daniel G. Whitney, PhD, and colleagues, these include both traditional and non-traditional urologic risk factors.
“A recent report suggests that the incidence of advanced CKD is 72% higher for adults with vs. without cerebral palsy after adjusting for cardiometabolic diseases, which are well-established risk factors for CKD,” the researchers wrote. “The findings suggest that there may be other factors, in addition to cardiometabolic diseases, that increase risk of advanced CKD specific to adults with cerebral palsy.”
Adding that advanced CKD is “irreversible, costly and fatal,” the researchers contended it is critical to prevent the onset of CKD or to slow its progression in this patient population. One method of doing this, Whitney and colleagues suggested, is to determine if medical conditions common to both cerebral palsy and CKD are associated with a higher incidence of advanced CKD.
For the study, 8,011 adults with cerebral palsy who did not have advanced CKD (stage 4 or later) were identified from a national, single, private payer administrative claims database.
During a mean follow-up of 1,062 days, 237 patients developed advanced CKD (interquartile range [IR] = 10.16 per 1,000 person years), with the researchers noting this is “considerably higher” than the IR of 6.24 of advanced CKD among adults without cerebral palsy or other neurodevelopmental disabilities.
While the researchers observed no difference between men and women in the development of advanced CKD, the crude IR of advanced CKD was highest among Hispanic patients.
After adjusting for predictor variables (including demographic variables and preexisting medical conditions), the researchers found the HR was elevated for older age, CKD stages 1 to 3 (HR = 3.32), diabetes (HR=2.69), hypertension (HR = 1.54), heart and cerebrovascular disease (HR = 1.53) and non-CKD urologic conditions (HR = 1.39).
Whitney and colleagues wrote that the findings suggest these medical conditions are robust risk factors for advanced CKD.
“Importantly, these medical conditions can be prevented, treated and properly managed in the clinical setting,” they concluded. “Future studies are needed to determine if better clinical management of these medical conditions can reduce or delay the risk of CKD development or progression to advanced stages for adults with cerebral palsy.”
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