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09:44 AM

KC Business Journal: Children's Mercy gets green light to expand kidney disease study

A massive, national chronic kidney disease study gained funding to study risk factors for children shortly after their diagnosis. More than a decade underway, the CKiD study was spearheaded by Children's Mercy and the Children's Hospital of Philadelphia in 2003, in response to a request for applications by the National Institutes of Health.

Since its inception, the study has brought together 54 different centers across the U.S. and followed more than 900 pediatric patients to determine what causes kidney disease to progress.

"Kidney disease is an under-appreciated problem. It really has a profound impact on these kids," said Dr. Bradley Warady, director of pediatric nephrology at Children's Mercy. "It's a lifelong illness you have to deal with."

To date, Dr. Warady and his team have used the data to track adverse outcomes associated with chronic kidney disease — such as hypertension or anemia — and what risk factors might lead to those. But despite working with pediatric patients, the median time after diagnosis for most participants was nine years, meaning the disease has already had a significant impact.

"These kids already had the disease for nine years — a lot has already happened in their life," Dr. Warady said.

Thanks to a new grant from NIH, the study will be able to enroll just under 200 additional patients, specifically less than five years after their diagnosis. For infants born with kidney disease, it can affect their growth, brain development and heart function early on.

"We may be able to tell what those factors are that lead to chronic kidney disease," Dr. Warady said. "Now, we can take everything we've learned over the past 14 years and apply it to these infants."

With the younger cohort of patients, he added, researchers might be able to follow them for up to 20 years. Warady and his team also will focus on patients with kidney failure, who have gone on to dialysis or a kidney transplant for treatment.

"We're looking now at both ends of the spectrum," Dr. Warady said. "Maybe could intervene and prevent it so they don't develop end-stage kidney disease."

So far, the results of the study have led to a bounty of information, and translated to better treatment strategies on the clinical side. For example, Warady's team discovered constant blood pressure monitoring revealed more pediatric patients with hypertension, a risk factor for developing heart disease later on. If physicians only measured patients' blood pressure when they came in, they could miss up to 38 percent of hypertension cases.

"It's crucial to the long-term outcome for these kids," Dr. Warady said. "Chronic kidney disease care has remarkably improved, in large part, because of data from CKiD."

With numerous specialists collaborating across the country, the study has resulted in 90 peer-reviewed papers, including two just this week. Next, they will apply for ongoing funding, to delve deeper into the genetics of kidney disease and patients' risk of developing complications. They also plan to monitor blood pressure using a device families can take home, and track patients' activity levels with a "Fitbit-like device."

"You can't do anything better than take care of kids," he said. "I've been doing this for 35 years. CKiD has to be one of the highlights of my career."


Read the article via the Kansas City Business Journal.

Learn more about nephrology or CKiD.