The association of anemia and hypoalbuminemia with accelerated decline in GFR among adolescents with chronic kidney disease

Susan L. Furth, Stephen R. Cole, Jeffrey J. Fadrowski, Arlene Gerson, Christopher B. Pierce, Manju Chandra, Robert Weiss, Frederick J. Kaskel

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

We sought to describe rates of kidney function decline and to identify modifiable risk factors for CKD progression in a multicenter prospective cohort study of adolescents with CKD aged 11 to 18 years seen semiannually for up to three years. Of the 23 subjects meeting inclusion criteria, the average estimated GFR was 51 ± 27 ml/min/1.73 m2 (0.85 ± 0.45 ml/s/1.73 m2) at entry. The overall annualized decline in GFR was 5.6 ml/min/ 1.73 m2 (0.093 ml/s/1.73 m2) per year (95% confidence interval [95% CI]: 1.9 to 9.3 [0.032 to 0.16]). The adjusted annualized decline in GFR was found to be accelerated in males, as well as among those over 15 years of age. The adjusted annualized decline in GFR was greater among those with either anemia (hematocrit below 36%), or hypoalbuminemia (albumin below 4 g/dl [40 g/L]). After adjustment, anemia was associated with an accelerated decline of 7.8 ml/min/ 1.73 m2 (0.13 ml/s/1.73 m2) (95% CI: 3.3 to 12 [0.055 to 0.20]) and hypoalbuminemia was associated with an accelerated decline of 17 ml/min/1.73 m2 (0.28 ml/s/1.73 m2) (95% CI: 11 to 22 [0.18 to 0.37]). Further study is needed to evaluate whether treatment of anemia or hypoalbuminemia, as outlined in current clinical care guidelines for CKD, may slow the progression of CKD in adolescents.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalPediatric Nephrology
Volume22
Issue number2
DOIs
StatePublished - Feb 2007

Fingerprint

Hypoalbuminemia
Chronic Renal Insufficiency
Anemia
Confidence Intervals
Hematocrit
Albumins
Cohort Studies
Prospective Studies
Guidelines
Kidney
Therapeutics

Keywords

  • Anemia
  • Chronic kidney disease
  • Hypoalbuminemia
  • Pediatrics
  • Progression

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

The association of anemia and hypoalbuminemia with accelerated decline in GFR among adolescents with chronic kidney disease. / Furth, Susan L.; Cole, Stephen R.; Fadrowski, Jeffrey J.; Gerson, Arlene; Pierce, Christopher B.; Chandra, Manju; Weiss, Robert; Kaskel, Frederick J.

In: Pediatric Nephrology, Vol. 22, No. 2, 02.2007, p. 265-271.

Research output: Contribution to journalArticle

Furth, Susan L. ; Cole, Stephen R. ; Fadrowski, Jeffrey J. ; Gerson, Arlene ; Pierce, Christopher B. ; Chandra, Manju ; Weiss, Robert ; Kaskel, Frederick J. / The association of anemia and hypoalbuminemia with accelerated decline in GFR among adolescents with chronic kidney disease. In: Pediatric Nephrology. 2007 ; Vol. 22, No. 2. pp. 265-271.
@article{cbc8f16f6ad1417c920b7b148224c637,
title = "The association of anemia and hypoalbuminemia with accelerated decline in GFR among adolescents with chronic kidney disease",
abstract = "We sought to describe rates of kidney function decline and to identify modifiable risk factors for CKD progression in a multicenter prospective cohort study of adolescents with CKD aged 11 to 18 years seen semiannually for up to three years. Of the 23 subjects meeting inclusion criteria, the average estimated GFR was 51 ± 27 ml/min/1.73 m2 (0.85 ± 0.45 ml/s/1.73 m2) at entry. The overall annualized decline in GFR was 5.6 ml/min/ 1.73 m2 (0.093 ml/s/1.73 m2) per year (95{\%} confidence interval [95{\%} CI]: 1.9 to 9.3 [0.032 to 0.16]). The adjusted annualized decline in GFR was found to be accelerated in males, as well as among those over 15 years of age. The adjusted annualized decline in GFR was greater among those with either anemia (hematocrit below 36{\%}), or hypoalbuminemia (albumin below 4 g/dl [40 g/L]). After adjustment, anemia was associated with an accelerated decline of 7.8 ml/min/ 1.73 m2 (0.13 ml/s/1.73 m2) (95{\%} CI: 3.3 to 12 [0.055 to 0.20]) and hypoalbuminemia was associated with an accelerated decline of 17 ml/min/1.73 m2 (0.28 ml/s/1.73 m2) (95{\%} CI: 11 to 22 [0.18 to 0.37]). Further study is needed to evaluate whether treatment of anemia or hypoalbuminemia, as outlined in current clinical care guidelines for CKD, may slow the progression of CKD in adolescents.",
keywords = "Anemia, Chronic kidney disease, Hypoalbuminemia, Pediatrics, Progression",
author = "Furth, {Susan L.} and Cole, {Stephen R.} and Fadrowski, {Jeffrey J.} and Arlene Gerson and Pierce, {Christopher B.} and Manju Chandra and Robert Weiss and Kaskel, {Frederick J.}",
year = "2007",
month = "2",
doi = "10.1007/s00467-006-0313-1",
language = "English (US)",
volume = "22",
pages = "265--271",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - The association of anemia and hypoalbuminemia with accelerated decline in GFR among adolescents with chronic kidney disease

AU - Furth, Susan L.

AU - Cole, Stephen R.

AU - Fadrowski, Jeffrey J.

AU - Gerson, Arlene

AU - Pierce, Christopher B.

AU - Chandra, Manju

AU - Weiss, Robert

AU - Kaskel, Frederick J.

PY - 2007/2

Y1 - 2007/2

N2 - We sought to describe rates of kidney function decline and to identify modifiable risk factors for CKD progression in a multicenter prospective cohort study of adolescents with CKD aged 11 to 18 years seen semiannually for up to three years. Of the 23 subjects meeting inclusion criteria, the average estimated GFR was 51 ± 27 ml/min/1.73 m2 (0.85 ± 0.45 ml/s/1.73 m2) at entry. The overall annualized decline in GFR was 5.6 ml/min/ 1.73 m2 (0.093 ml/s/1.73 m2) per year (95% confidence interval [95% CI]: 1.9 to 9.3 [0.032 to 0.16]). The adjusted annualized decline in GFR was found to be accelerated in males, as well as among those over 15 years of age. The adjusted annualized decline in GFR was greater among those with either anemia (hematocrit below 36%), or hypoalbuminemia (albumin below 4 g/dl [40 g/L]). After adjustment, anemia was associated with an accelerated decline of 7.8 ml/min/ 1.73 m2 (0.13 ml/s/1.73 m2) (95% CI: 3.3 to 12 [0.055 to 0.20]) and hypoalbuminemia was associated with an accelerated decline of 17 ml/min/1.73 m2 (0.28 ml/s/1.73 m2) (95% CI: 11 to 22 [0.18 to 0.37]). Further study is needed to evaluate whether treatment of anemia or hypoalbuminemia, as outlined in current clinical care guidelines for CKD, may slow the progression of CKD in adolescents.

AB - We sought to describe rates of kidney function decline and to identify modifiable risk factors for CKD progression in a multicenter prospective cohort study of adolescents with CKD aged 11 to 18 years seen semiannually for up to three years. Of the 23 subjects meeting inclusion criteria, the average estimated GFR was 51 ± 27 ml/min/1.73 m2 (0.85 ± 0.45 ml/s/1.73 m2) at entry. The overall annualized decline in GFR was 5.6 ml/min/ 1.73 m2 (0.093 ml/s/1.73 m2) per year (95% confidence interval [95% CI]: 1.9 to 9.3 [0.032 to 0.16]). The adjusted annualized decline in GFR was found to be accelerated in males, as well as among those over 15 years of age. The adjusted annualized decline in GFR was greater among those with either anemia (hematocrit below 36%), or hypoalbuminemia (albumin below 4 g/dl [40 g/L]). After adjustment, anemia was associated with an accelerated decline of 7.8 ml/min/ 1.73 m2 (0.13 ml/s/1.73 m2) (95% CI: 3.3 to 12 [0.055 to 0.20]) and hypoalbuminemia was associated with an accelerated decline of 17 ml/min/1.73 m2 (0.28 ml/s/1.73 m2) (95% CI: 11 to 22 [0.18 to 0.37]). Further study is needed to evaluate whether treatment of anemia or hypoalbuminemia, as outlined in current clinical care guidelines for CKD, may slow the progression of CKD in adolescents.

KW - Anemia

KW - Chronic kidney disease

KW - Hypoalbuminemia

KW - Pediatrics

KW - Progression

UR - http://www.scopus.com/inward/record.url?scp=33845684347&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845684347&partnerID=8YFLogxK

U2 - 10.1007/s00467-006-0313-1

DO - 10.1007/s00467-006-0313-1

M3 - Article

C2 - 17120062

AN - SCOPUS:33845684347

VL - 22

SP - 265

EP - 271

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 2

ER -