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                    Kidney Disease
                    Chronic Kidney Disease in Children Study: CKiD

    Related Topics
        Kidney Disease
        Chronic Kidney Disease in Children Study: CKiD
                Effects of Chronic Kidney Disease in Adults Study: CRICChronic Kidney Disease in Children Study: CKiD
    The 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 or heart and blood vessel disease
    cognitive development or the brain’s ability to think, remember, or reason
    quality of life
    growthA better understanding of the risk factors that lead to CKD may result in clinical trials to improve the health outcomes of children with CKD.
In newborns and younger children, kidney disease is most often caused by birth defects that lead to problems with kidney and urinary tract development. In older children, kidney disease is most often caused by inherited diseases that are passed from parent to child or systemic diseases that children develop involving many organs in the body. In children and teens with kidney disease, obesity can increase the severity of kidney disease, risk of cardiovascular disease, and risk of type 2 diabetes later in life.
Results
Information from the CKiD Study is still being gathered. So far, the study has helped researchers develop better screening tools and treatments for CKD and its complications. It has also helped researchers better understand the causes of CKD and the relationship between CKD and the risk for cardiovascular disease, cognitive development, other complications, and racial disparities.
Screening and Treatment for CKD
Results from the study led to more accurate tools to evaluate kidney function in children and teens. Results from the study also helped the medical community improve screening and treatment for conditions that occur in children and teens with CKD. For example, researchers
developed techniques to help estimate how much time children with CKD have before needing kidney transplants
    found that CKD progresses more quickly in children whose blood contains more uric acid than normal. Researchers are using this information to see if they can slow CKD progression in children and adolescents by trying to lower their uric acid levels
    found that certain types of drugs that control blood pressure might lengthen the time before children with CKD need kidney transplants
Causes of CKD
The study showed that some participants without any known family history of kidney disease had an inherited cause for CKD and
about 7 percent of participants had changes in a group of genes known to be linked with kidney disease and other genes thought to be related to kidney disease
    some of these genes are linked to a higher risk for problems, such as cardiovascular disease
Risk for Cardiovascular Disease
The study showed that
about half of the children and teens had signs of cardiovascular disease including high blood pressure, structural changes of the heart and blood vessels, and abnormal levels of blood fats at the start of the study
    children and teens with low kidney function also had the highest chance of having abnormally high levels of blood fats
Cognitive Development
The study found links between CKD and children’s cognitive development. For example,
about 20 to 40 percent of participants had delays in cognitive development and scored lower on IQ and other tests at the start of the study
    children with mild to moderate CKD whose blood pressure varied greatly from visit to visit scored lower on tests that measure brain function than children whose blood pressure was more stable
Other Complications
The study 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
    children and teens who had a low birth weight or who were small for their gestational age may also have slowed growth
    children whose kidney function was lower than that of other children with CKD were more likely to report a decreased appetite over a year; and those whose appetite decreased were more likely to be hospitalized and report a poorer quality of life
Racial Disparities
The study showed specific risk factors for the development and progression of CKD in African American children, including
premature birth
    low birth weight
    inherited genes that increase the risk of developing CKD
Researchers are studying how these risk factors interact with societal disparities, such as
lack of access to timely health care
    unequal health care treatment
    socioeconomic status (education, employment, and income)
    neighborhood and environmental factors
    racial biases
    potential bias in access to kidney transplants
Study Size, Participant Demographics, and Study Design
The CKiD Study started in 2005 and is ongoing. CKiD involves over 1,000 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 cognitive development. Participants also provided information used to assess quality of life and behavior.
The CKiD Study is taking place at more than 50 medical centers in the United States and Canada.
Related Health Information
Kidney Disease in Children
News Releases and Reports
Growth more stunted in lower-income youth with kidney disease
    This National Kidney Month, help your children adopt healthy habits
    Complications of chronic kidney disease occur earlier in children
Scientific Publications and Resources
CKiD Study Website
    CKiD Study on ClinicalTrials.gov
    Study Documents and Resources from the NIDDK Central Repository
    CKiD Grant Award Information from dkNET
    Verbitsky M, Westland R, Perez A, et al. The copy number variation landscape of congenital anomalies of the kidney and urinary tract [published correction appears in *Nature Genetics*. 2019;51(4):764]. *Nature Genetics*. 2019;51(1):117–127. doi:10.1038/s41588-018-0281-y
    Wong CJ, Moxey-Mims M, Jerry-Fluker J, Warady BA, Furth SL. CKiD (CKD in Children) prospective cohort study: a review of current findings. *American Journal of Kidney Diseases*. 2012;60(6):1002–1011. doi:10.1053/j.ajkd.2012.07.018
    Moxey-Mims M.Kidney disease in African American children: biological and nonbiological disparities. *American Journal of Kidney Diseases*. 2018 Nov;73(5):S17–S21. doi:1053/j.ajkd.2018.06.025
    Warady BA, Abraham AG, Schwartz GJ, et al. Predictors of rapid progression of glomerular and nonglomerular kidney disease in children and adolescents: the Chronic Kidney Disease in Children (CKiD) Cohort. *American Journal of Kidney Diseases*. 2015;65(6):878–888. doi:10.1053/j.ajkd.2015.01.008
    Ayestaran FW, Schneider MF, Kaskel FJ, et al. Perceived appetite and clinical outcomes in children with chronic kidney disease. *Pediatric Nephrology (Berlin, Germany)*. 2016;31(7):1121–1127. doi:10.1007/s00467-016-3321-9
    Lande MB, Mendley SR, Matheson MB, et al. Association of blood pressure variability and neurocognition in children with chronic kidney disease. *Pediatric Nephrology (Berlin, Germany)*. 201631(11):2137–2144. doi:10.1007/s00467-016-3425-2
    Abraham AG, Betoko A, Fadrowski JJ, et al. Renin-angiotensin II-aldosterone system blockers and time to renal replacement therapy in children with CKD. *Pediatric Nephrology (Berlin, Germany)*. 2017;32(4):643–649. doi:10.1007/s00467-016-3512-4
    Atkinson MA, Ng DK, Warady BA, Furth SL, Flynn JT. The CKiD Study: Overview and summary of findings related to kidney disease progression. *Pediatric Nephrology (Berlin, Germany)*. 2020;10.1007/s00467-019-04458-6. doi:10.1007/s00467-019-04458-6
    Brady TM, Roem J, Cox C, et al. Adiposity, sex, and cardiovascular disease risk in children with CKD: a longitudinal study of youth enrolled in the Chronic Kidney Disease in Children (CKiD) Study. *American Journal of Kidney Diseases*. 2020;76(2):166–173. doi:10.1053/j.ajkd.2020.01.011
    Madueme PC, Ng DK, Guju L, et al. Aortic dilatation in children with mild to moderate chronic kidney disease [published correction appears in *Pediatric Nephrology (Berlin, Germany)*. 2020;35(10):2017]. *Pediatric Nephrology (Berlin, Germany)*. 2020;35(6):1023–1031. doi:10.1007/s00467-019-04469-3
    Reynolds BC, Roem JL, Ng DKS, et al. Association of time-varying blood pressure with chronic kidney disease progression in children. *JAMA Network Open*. 2020;3(2):e1921213. Published February 5, 2020. doi:10.1001/jamanetworkopen.2019.21213
    Harshman LA, Johnson RJ, Matheson MB, et al. Academic achievement in children with chronic kidney disease: a report from the CKiD cohort. *Pediatric Nephrology (Berlin, Germany)*. 2019;34(4):689–696. doi:10.1007/s00467-018-4144-7
    Ng DK, Matheson MB, Warady BA, Mendley SR, Furth SL, Muñoz A. Incidence of initial renal replacement therapy over the course of kidney disease in children. *American Journal of Epidemiology*. 2019;188(12):2156–2164. doi:10.1093/aje/kwz220
        Last Reviewed May 2023 Contact Us
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