Children with chronic kidney disease (CKD) are at higher risk of longer hospital stays and mortality risk when compared with other chronic conditions.* One reason for this statistic is because many children with CKD suffer from other health conditions, like cardiovascular disease or diabetes.

According to Michigan Medicine pediatric nephrologist, Dr. Zubin Modi, who studied the impact of CKD on children, found that “chronic kidney disease is a lifelong health issue that puts an outsized burden on children’s lives,” one such burden being complications from CKD.

Children at risk of complications

Chronic kidney disease progression can lead to dysfunction of kidney structure or function, which may lead to end-stage kidney disease (ESKD) that requires dialysis or an organ transplant. 

CKD can also put children at risk of:

• Infection
• Dehydration
• Side effects related to medications

Since many pediatric CKD patients also have multiple other chronic health conditions, such as cardiovascular disease, hypertension, or diabetes, they can adversely impact outcomes. These complications can be both dangerous and costly. 

The burden of pediatric kidney disease

Researchers looked at data for four years and found that of the 6.5 million national pediatric hospital discharges, about 4% were associated with children with chronic kidney disease, according to the findings published in the American Journal of Kidney Diseases.

The new research found that children with CKD spent about an average of 2.8 days longer in the hospital compared with 1.8 days for those without CKD. They also made up about 60% more in hospital expenses, $8,755 per hospitalization compared with $5,016.

The authors found that these high healthcare expenses may be comparable to those of patients with heart failure—one of the symptoms of heart disease—the most common cause of death. Children with CKD were also 50% more likely to die during their hospital stay. Dr. Modi shares that this fact alone “…should prompt providers to closely evaluate management strategies.” 

This makes putting pediatric CKD at the top of the list of diseases to fully understand and address in a way that reduces the burden on children and society vital.

Looking at next steps

The study’s findings suggest that since children with CKD have very complex health needs, it is important to determine more effective ways to provide them with the care they need before, during, and after hospitalization.

One suggestion is to bring nephrologists earlier in the process if they are not already involved in patients’ care. They could ensure patients avoid medications that worsen kidney function and suggest other steps that will improve care for these patients, according to Dr. Modi.

Since CKD can come with many long-term consequences and can impact patients’ lives through adulthood, further studies are also needed to understand the healthcare needs and quality of care in hospitalized children with CKD to improve their quality of life.

*Mostafavi, B. (2020, Oct. 12). Children with Chronic Kidney Disease Have Outsized Health Burden. University of Michigan Health. https://labblog.uofmhealth.org/rounds/children-chronic-kidney-disease-have-outsized-health-burden