Proteinuria as a predictor of disease progression in children with hypodysplastic nephropathy. Data from ItalKid Project

Little is known about the role of proteinuria in the progression of childhood renal diseases. We analyzed the decline in creatinine clearance (C^Cr) and kidney survival in 225 children (185 males) with chronic renal failure (CRF) due to isolated hypodysplasia or hypodysplasia associated with urological abnormalities. The data were based on the information available in the Italian Pediatric Registry of CRF (ItalKid Project), which includes patients from all of Italy aged Cr levels of 2. Patients aged Cr levels of 2, or a follow-up of Cr of 50±16.3 ml/min per 1.73 m², a median urinary protein/urinary creatinine (uPr/uCR) ration of 0.38 (range 0.02-7.21), and a mean duration of follow-up of 3.5±1.1 years. The patients were divided into three groups on the basis of their baselie proteiuria levels; group A normal (uPr/uCr0.2) n=83; group B low (uPruCr 0.2-0.9) n=71; and group C mild (uPr/uCr>0.9) n=71. Patients in group A and B showed a significantly slower decline in C^Cr than those in group C (slope +0.16±3.64 and -0.54±3.67 vs. -3.61±5.47, PCr irrespective of baseline C^Cr. There was no correlation with mean arterial blood pressure. We conclude that proteinuria is an independent predictor of progression to end-stage renal failure also in children whose renal impairment is due to congenital hypodysplasia.