Pediatric chronic kidney disease (CKD) results from a variety of health conditions that reduce kidney function. CKD can progress to end-stage kidney disease (ESKD), which requires dialysis or kidney transplant. While CKD in adults is common and mainly caused by hypertension and diabetes, CKD in children is relatively rare, and caused primarily by congenital anomalies of the genitourinary system and immune-mediated disorders. Hypertension is estimated to occur in about half of children with CKD, and is thought to be a major risk factor for worsening of kidney function.
Dorey Glenn, MD, MPH, assistant professor of medicine in the division of nephrology and hypertension, is leading the PRESERVE study at UNC Children’s Hospital. The study, which is centered at the Children’s Hospital of Philadelphia, is comprised of 16 centers from across the United States. The PRESERVE study will use medical record data from over 11,000 children with CKD to answer important questions regarding blood pressure management for children with many forms of CKD.
“Over time, loss of kidney function results in end-stage kidney disease, which requires long-term dialysis or kidney transplantation,” said Glenn. “Hypertension is a major and potentially modifiable contributor to loss of kidney function. Delaying loss of kidney function is a high priority for patients and families, and of great interest to the kidney research community.”
Regardless of how CKD came about, treatment focuses on controlling blood pressure with medications. And better, evidence-based guidelines are needed to effectively manage blood pressure in children. The PRESERVE trial aims to:
- Expand and improve the PCORnet common data model for research in children with kidney disease by adding new pediatric- and kidney-specific variables and linking patients’ electronic health record (EHR) data to other kidney disease databases.
- Compare the effectiveness of alternative strategies for monitoring and treating hypertension on preserving kidney function.
- Assess the lived experiences of patients and caregivers related to BP management.
Glenn says the project will set the stage for future research, such as clinical trials on blood pressure control strategies in pediatric CKD.