Pediatric Chronic Kidney Disease Treatment Study

A retrospective single-center study published in the American Journal of Nephrology highlighted a potential treatment in pediatric chronic kidney disease (CKD) treatment. The study found promising results of an SGLT2 inhibitor, dapagliflozin, among the pediatric patients with CKD.

Nephroprotection in pediatric CKD has long been a crucial concern to preserve the residual renal function and enhance the quality of life while delaying the need for renal replacement therapy. The treatment options for pediatric CKD have been predominantly limited to angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers so far. However, recent trials conducted in adults with CKD have suggested that SGLT2 inhibitors might offer significant benefits to pediatric patients.

Study Overview

The retrospective study by Olil Van Reeth and team assessed the safety profile and potential renal protective effects of dapagliflozin among pediatric CKD patients. The study included 7 patients with an average age of 13.3 years who were already undergoing treatment with ACE inhibitors for identified glomerulopathy that leads to CKD.

Key Findings

• During the 15-month observation period, all patients reported dapagliflozin as easy to use.
• After an initial decline, the slope of estimated glomerular filtration rate (eGFR) stabilization was observed in all patients.
• The urinary albumin over creatinine ratio displayed a strong tendency to decrease after six months of treatment, indicating potential renal protection.
• Systolic blood pressure also showed a tendency to decrease after the same duration of treatment.
• No significant side effects were reported by any of the patients, highlighting the tolerability of dapagliflozin in this population.

The findings of this study illuminate the potential of SGLT2 inhibitors in pediatric CKD management. While larger, randomized-controlled trials are imperative to further elucidate their effectiveness and safety profile in this specific demographic, these preliminary results represent a significant step forward in the quest for enhanced treatments for pediatric CKD. The outcomes offer hope for thousands of children worldwide with CKD by paving the way for more tailored and effective interventions to enhance their quality of life and long-term health outcomes.

This research helps in the management of pediatric CKD by potentially delaying the progression of the disease and improving the quality of life for affected children. Future studies might find dapagliflozin and similar SGLT2i drugs to emerge as valuable additions to the existing treatments for pediatric CKD for improving nephroprotection for young patients with this chronic condition.

Reference

Van Reeth, O., Caliment, A., de la Fuente Garcia, I., & Niel, O. (2024). Safety profile and effectiveness of dapagliflozin in pediatric patients with chronic kidney disease. American Journal of Nephrology. https://doi.org/10.1159/000539300