Alternative Approaches for Managing Blood Pressure in Children with Chronic Kidney Disease (PRESERVE 2.0)
Research question: What clinic BP threshold should be targeted for kidney and cardiovascular protection in children with CKD? Should RAASi be first-line anti-hypertensive therapy for all children with CKD? Aims: Aim 1: Establish the pragmatic trial infrastructure by building on…
Effects of PTH on Rates of Skeletal Fractures in CKD
The purpose of this study is to understand the effects of parathyroid hormone levels on risks of skeletal fractures among children with chronic kidney disease. Investigators will utilize the existing row-level PEDSnet dataset previously created to examine the effects of…
Alkali therapy and Linear Growth in Children with CKD
Children with chronic kidney disease (CKD) have higher rates of hospitalizations, metabolic abnormalities, cardiovascular disease, and growth restriction, compared to their healthy counterparts. 1-4 Growth failure is common in pediatric CKD; affecting up to 35% of these children. 5 Children…
Acute Kidney Injury Phenotypes and Long-Term Major Adverse Kidney Events
The purpose of our study is to evaluate the long-term outcomes after AKI in critically ill children and identify the risk factors associated with these outcomes. Our central hypothesis is that long-term major adverse kidney events (MAKE; a composite of…
PKDnet: ARPKD Learning Network
Autosomal recessive polycystic kidney disease (ARPKD) is a rare disease, affecting ~1,500 children and young adults in the U.S. In severely affected patients, ARPKD can present in the neonatal period with massively enlarged kidneys and pulmonary hypoplasia, but the clinical…
PCEN: Impact of social drivers of health on pediatric kidney transplant outcomes
Organs are a limited resource that must be rationed. There are over 103,000 individuals on the national transplant waiting list in the United States and many will die while waiting for a transplant. Thus equitable allocation and responsible stewardship of…
Acute Kidney Injury (AKI) in Children with Chronic Kidney Disease (CKD)
Acute kidney injury (AKI) is defined as an abrupt loss of kidney function and is very common in children with chronic kidney disease (CKD). AKI is associated with high mortality rates in children and is thought to be a risk…
USDHub: Urologic community resource network
The Urinary Stone Disease Hub (USDHub) is an innovative research initiative designed to advance the understanding, treatment, and prevention of urinary stone disease (USD), a condition that affects over 11% of the U.S. population and incurs healthcare costs exceeding $10…
Detection of and Characteristics of Disease Progression in Children with CKD
The purpose of this study was to inform the design of a possible clinical trial in children with chronic kidney disease. Our goals were to use the PEDSnet EHR database to: 1. Identify a population of children ages 6 months…
Developing a class of MSMs to estimate the effect of time-varying treatments on different types of recurrent time-to-event outcomes
Pragmatic trials and comparative effectiveness research often require causal inference methods to establish cause-effect relationships between interventions and outcomes. With treatments that can change over time, it is crucial to account for time-dependent confounders to accurately estimate treatment effects. Statistical…
Computational Phenotype of Acute and Long-term Kidney Disease in Children with Septic Shock
This study aims to expand understanding of how crystalloid fluid impacts sepsis survivors’ lives beyond 30 days. Aim 1: Determine the most effective crystalloid fluid choice to minimize sepsis-induced AKI and CKD in PRoMPT BOLUS trial participants Aim 2: Measure…
P50 Projects – CHOP Pediatric Center for Excellence in Nephrology (PCEN)
With this renewal, the Pediatric Center of Excellence in Nephrology at the Children’s Hospital of Philadelphia (CHOP PCEN) will continue to facilitate extensive collaborative research around the causes, diagnoses, and treatment of childhood kidney diseases. Increasing efficiency and effectiveness, the…
Treatment of Henoch-Schonlein purpura (HSP) Nephritis
Henoch-Schonlein purpura (HSP) is one of the most common forms of vasculitis in children, with an incidence of around 6-24 cases per 100,000 per year and with 90% of cases presenting before age ten. While many cases are self-limited, 30-50%…
Feasibility of N-of-1 Trials in Children with Hypertension and Chronic Kidney Disease (NICHE-CKD) study
Hypertension (HTN) contributes to progression of renal failure and is an important modifiable risk factor for cardiovascular (CV) morbidity/mortality. Little is known about whether any specific medications are more effective than others in reducing BP for these patients, or whether…
Preserving Kidney Function in Children with Chronic Kidney Disease
Chronic kidney disease, or CKD, is a health problem in which the kidneys don’t work well to remove waste from the blood. About half of all children with CKD also have high blood pressure, which increases their risk of kidney…
Comparative effectiveness of treatments for recurrent focal segmental glomerulosclerosis in pediatric kidney transplantation
Background Recurrence of focal segmental glomerulosclerosis (FSGS) or steroid-resistant nephrotic syndrome (SRNS) after kidney transplant leads to significant morbidity and potentially earlier allograft loss. To date, however, reported rates, risk factors, and treatment outcomes have varied widely. Methods We applied…
Utilization of PEDSnet to create a novel classifier for children with nephrotic syndrome using aggregated clinical and genetic testing data
Nephrotic syndrome (NS) is a leading cause of acquired end-stage kidney disease (ESKD) in children. The incidence of NS is approximately 2-5 per 100,000 children and its pathogenesis is not fully understood. Children with NS are classified based on: 1)…
Skeletal Outcomes in Children and Young Adults with Glomerular Disease
Children and adolescents with glomerular disease have unique and potentially modifiable risk factors for compromised bone health. As delineated by the applicant’s K23 project, glomerular disease is associated with multiple disturbances in vitamin D homeostasis and mineral metabolism, independent of…
GLEAN Membranoproliferative Glomerulonephritis (MPGN) Project
C3 Glomerulopathy (C3G) and Immune Complex-associated Membranoproliferative Glomerulonephritis (IC-MPGN) are kidney diseases with different causes. C3G results from problems with the alternative complement pathway, while IC-MPGN is linked to the classical complement pathway due to immune complex formation. These conditions…
GLEAN Membranoproliferative Glomerulonephritis (MPGN) Project
C3 Glomerulopathy (C3G) and Immune Complex-associated Membranoproliferative Glomerulonephritis (IC-MPGN) are kidney diseases with different causes. C3G results from problems with the alternative complement pathway, while IC-MPGN is linked to the classical complement pathway due to immune complex formation. These conditions…
Pediatric Glomerular Disease Learning Network
The goal of this study is to create a sustainable and expandable Pediatric Glomerular Disease Learning Network to address fundamental limitations of current observational cohorts and registries and focus on practice pattern variation, observational outcomes and comparative effectiveness research, and…
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