U.S. Department of Health and Human Services

Chronic Kidney Disease in Children Study: CKiD

Purpose

NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); National Heart, Lung, and Blood Institute (NHLBI); and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) fund the Chronic Kidney Disease in Children Study (CKiD) to define risk factors that lead to the development of chronic kidney disease (CKD) in children and how CKD progression affects:

  • factors that raise the risk for cardiovascular disease (CVD) or heart and blood vessel disease
  • neurocognitive or brain-related function
  • quality of life, and
  • growth

A better understanding of the risk factors that lead to CKD may result in research trials to improve the health outcomes of children with CKD.

In infants and younger children, kidney disease is most often due to birth defects that lead to problems in the development of the kidneys and the rest of the urinary tract. As children get older, diseases that cause kidney inflammation become more common. In teenagers, type 2 diabetes and high blood pressure are increasingly more common, especially in those who have obesity. Obesity in children and teens may lead to health problems such as high blood pressure, high blood cholesterol, diabetes, and kidney disease later in life.

Results

Information from the CKiD Study is still being gathered. Results from the study so far have led to better tools to evaluate kidney function in children and teens. Results also have given the medical community important information to improve screening and treatment for conditions that occur as complications in children and teens with CKD.

To date, the study has given researchers a better understanding of the causes of CKD. Study results showed that some participants without any known family history of kidney disease actually had an inherited cause for CKD. About 7 percent of participants had changes in 10 genes known to be linked with kidney disease and other genes thought to be related to kidney disease. Some of these genes are also linked to a higher risk for problems such as heart disease, a leading cause of death in people with kidney failure; diabetes; eye disease; or nerve problems.

Researchers also found that about half of the children and teens had high blood pressure—a type of CVD—and abnormal levels of blood fats (a risk factor for CVD) at the start of the study. Children and teens with lower kidney function also had the highest chance of having abnormally high levels of blood fats.

Other study results showed that almost half (45 percent) of the participants had anemia, which can lead to other health problems, including poor or slowed growth, and death. Researchers also found that children and teens who had a low birthweight or who were small-for-gestational-age may also show poor growth. Additional results showed that about 20 to 40 percent of participants had delays in brain development and scored lower on IQ and other tests at the start of the study. In addition, researchers found that minority children and teens are most at risk for CKD.

Study Size, Participant Demographics, and Study Design

The CKiD Study started in 2005 and is ongoing. CKiD involves close to 900 children with mild to moderate kidney disease. To take part in the study, participants could not have had dialysis treatment within 3 months of study enrollment.

At the beginning and throughout the study, the participants received physical examinations and blood and urine tests to check for kidney and heart issues, and special tests that check brain function, and growth. Participants also provided information used to assess quality of life and behavior.

The CKiD Study is taking place at more than 40 medical centers in the United States and Canada.

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