EHR can provide data to identify risk factors for kidney function decline in children
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Researchers successfully used data from electronic health records to determine risk factors for kidney function decline in children with chronic kidney disease, according to a published study.
According to results in the Clinical Journal of the American Society of Nephrology, risk factors included disease etiology, albuminuria, hypertension, age, male sex and lower eGFR.
“The overarching goal of this project was to demonstrate that real world EHR data can be used to model kidney function decline in children. Chronic kidney disease in children is rare and as such there are few high-quality studies that inform clinical decision-making,” Caroline A. Gluck, MD, from the division of pediatric nephrology at Nemours Children’s Health in Delaware, told Healio. “Landmark prospective epidemiologic studies, like [Chronic Kidney Disease in Children] CKiD, have been invaluable to our understanding of CKD. However, in contrast to prospective cohort studies, this study represents an unbiased sample of the U.S. source population and to our knowledge represents the largest cohort of children with CKD to date.”
In a retrospective cohort study, researchers examined data of 11,240 children with CKD between Jan. 1, 2009, and Feb. 28, 2022. Data were derived from PEDSnet, a network with EHR data from inpatients and outpatient settings across six children’s health care organizations in the U.S. Patients had two eGFR values less than 90 mL/min per 1.73 m2 and at least 15 mL/min per 1.73m2 separated by at least 90 days without an intervening value at least 90 mL/min per 1.73 m2. Researchers identified three subcohorts of children based on CKD etiology: glomerular, nonglomerular and malignancy associated.
Researchers conducted a median follow-up of 5.1 years and considered CKD progression and long-term dialysis the composite outcomes of the study.
Additionally, researchers measured the correlation of hypertension and proteinuria within 2 years of joining the cohort on the composite outcome.
Overall, the median initial eGFR was 75.3 mL/min per 1.73 m2. Of the patients included in the study, 37% had proteinuria and 35% had hypertension. Analyses revealed disease etiology, albuminuria, hypertension, age, male sex, lower eGFR and greater medical complexity at start of follow-up correlated with a faster decline in kidney function among children with CKD.
Gluck and colleagues noted that this study can serve as a roadmap for use of EHR data networks to power the study of rare diseases, such as pediatric CKD.
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