The National Institute of Diabetes and Digestive and
Kidney Diseases has awarded Susan L. Furth, a pediatric
nephrologist at the
Johns Hopkins
Children's Center, a $3 million five-year grant to
study chronic kidney disease in children.
The multicenter study will focus on identifying and
understanding the risk factors that lead to rapid
progression of kidney disease and, in some cases, kidney
failure. National enrollment of 600 children with moderate
to severe kidney disease will begin in the late spring of
2004.
This cooperative effort will be led by Furth, along
with Bradley Warady, of the Children's Mercy Hospital in
Kansas City, Mo., and Alvaro Munoz, of the Johns Hopkins
Bloomberg School of Public
Health.
"There have been no known large-scale prospective
studies of pediatric chronic kidney disease, which is a
'silent' or asymptomatic disease, meaning some children may
not be diagnosed until the disease has advanced to the
point of kidney failure," said Furth, who will serve as the
primary Hopkins investigator.
"We hope that by defining and understanding risk
factors that lead to faster progression of the disease we
can intervene early to slow or prevent kidney failure
further down the road," she said.
Furth and her team will focus on several known adverse
effects of chronic kidney disease, or CKD, including:
Cardiovascular disease: Children with CKD have a
higher incidence of hypertension as their damaged kidneys
are unable to produce the hormone renin, which regulates
blood pressure; this may make these children more
susceptible to heart disease.
Growth failure: Short stature is a common occurrence
among children with CKD, also due to a lack of production
or decreased responsiveness to certain regulatory hormones,
specifically those responsible for red blood cell
production and bone growth.
Cognitive and behavioral development: Researchers
suspect depression as well as memory and learning may be
affected by a decrease in brain and central nervous system
functions, possibly caused by CKD-induced anemia.
"Even though children represent a small population of
all patients with kidney disease, it's possible some of the
risk factors that we identify in children may be applicable
to adults, particularly those involving neurocognitive
functioning and heart disease," Furth said.
According to the National Kidney Foundation, more than
20 million Americans — one in nine adults —
have chronic kidney disease. Approximately 5,000 children
in the United States have end-stage renal disease, or
kidney failure, Furth said.
Patients interested in participating in the study
should contact Susan Furth at 410-502-7964 or sfurth@jhmi.edu.
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