Warady et al reported models for the progression of kidney disease in children. One model was for children with non-glomerular kidney disease. The authors are from multiple institutions in the United States.
Patient selection: pediatric patient with non-glomerular kidney disease from 1 to 16 years of age
Outcome: progression of kidney dysfunction with either initiation of renal replacement therapy (dialysis or transplant) or a 50% reduction in GFR
Parameters:
(1) age in years
(2) sex
(3) GFR in mL per min per 1.73 square m
(4) serum albumin in g/dL
(5) blood pressure percentile
(6) dyslipidemia (triglycerides > 130 mg/dL, HDL cholesterol < 40 mg/dL, or non-HDL cholesterol > 160 mg/dL)
(7) nephrotic proteinuria (urine protein to creatinine ratio > 2 mg per mg)
(8) anemia (< 5th percentile for age and sex)
(9) ACE/ARB therapy
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
-0.03 * (age)
|
|
sex
|
female
|
0
|
|
|
male
|
-0.20
|
|
GFR
|
> 45
|
0
|
|
|
30 to 45
|
-0.27
|
|
|
< 30
|
-0.83
|
|
serum albumin
|
>= 3.8 g/dL
|
0
|
|
|
< 3.8 g/dL
|
-0.67
|
|
blood pressure
|
<= 90th percentile
|
0
|
|
|
> 90th percentile
|
-0.32
|
|
dyslipidemia
|
no
|
0
|
|
|
yes
|
-0.15
|
|
nephrotic proteinuria
|
onset
|
-1.07
|
|
|
persistent
|
-1.19
|
|
|
resolution
|
-0.77
|
|
|
none
|
0
|
|
anemia
|
onset
|
-0.40
|
|
|
persistent
|
-0.56
|
|
|
resolution
|
-0.30
|
|
|
none
|
0
|
|
ACE/ARB
|
initiation
|
-0.51
|
|
|
persistent
|
-0.31
|
|
|
discontinuation
|
-0.05
|
|
|
none
|
0
|
total score =
= SUM(points for all 9 parameters) + 3.58
median time to composite event in years =
= EXP(total score)
