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Sood MM, Murphy MSQ, Hawken S, et al. Association Between Newborn Metabolic Profiles and Pediatric Kidney Disease. Kidney Int Rep. 2018;3(3):691-700doi: 10.1016/j.ekir.2018.02.001.
Sood, M. M., Murphy, M. S. Q., Hawken, S., Wong, C. A., Potter, B. K., Burns, K. D., Tsampalieros, A., Atkinson, K. M., Chakraborty, P., & Wilson, K. (2018). Association Between Newborn Metabolic Profiles and Pediatric Kidney Disease. Kidney international reports, 3(3), 691-700. https://doi.org/10.1016/j.ekir.2018.02.001
Sood, Manish M, et al. "Association Between Newborn Metabolic Profiles and Pediatric Kidney Disease." Kidney international reports vol. 3,3 (2018): 691-700. doi: https://doi.org/10.1016/j.ekir.2018.02.001
Sood MM, Murphy MSQ, Hawken S, Wong CA, Potter BK, Burns KD, Tsampalieros A, Atkinson KM, Chakraborty P, Wilson K. Association Between Newborn Metabolic Profiles and Pediatric Kidney Disease. Kidney Int Rep. 2018 Feb 10;3(3):691-700. doi: 10.1016/j.ekir.2018.02.001. eCollection 2018 May. PMID: 29854978; PMCID: PMC5976820.
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Kidney Int Rep. 2018 Feb 10;3(3):691-700. doi: 10.1016/j.ekir.2018.02.001. eCollection 2018 May.

Association Between Newborn Metabolic Profiles and Pediatric Kidney Disease.

Kidney international reports

Manish M Sood, Malia S Q Murphy, Steven Hawken, Coralie A Wong, Beth K Potter, Kevin D Burns, Anne Tsampalieros, Katherine M Atkinson, Pranesh Chakraborty, Kumanan Wilson

Affiliations

  1. The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  2. Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada.
  3. Clinical Epidemiology Program, University of Ottawa, Ontario, Canada.
  4. Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
  5. Kidney Research Centre, University of Ottawa, Ottawa, Ontario, Canada.
  6. Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

PMID: 29854978 PMCID: PMC5976820 DOI: 10.1016/j.ekir.2018.02.001

Abstract

INTRODUCTION: Metabolomics offers considerable promise in early disease detection. We set out to test the hypothesis that routine newborn metabolic profiles at birth, obtained through screening for inborn errors of metabolism, would be associated with kidney disease and add incremental information to known clinical risk factors.

METHODS: We conducted a population-level cohort study in Ontario, Canada, using metabolic profiles from 1,288,905 newborns from 2006 to 2015. The primary outcome was chronic kidney disease (CKD) or dialysis. Individual metabolites and their ratio combinations were examined by logistic regression after adjustment for established risk factors for kidney disease and incremental risk prediction measured.

RESULTS: CKD occurred in 2086 (0.16%, median time 612 days) and dialysis in 641 (0.05%, median time 99 days) infants and children. Individual metabolites consisted of amino acids, acylcarnitines, markers of fatty acid oxidation, and others. Base models incorporating clinical risk factors only provided c-statistics of 0.61 for CKD and 0.70 for dialysis. The addition of identified metabolites to risk prediciton models resulted in significant incremental improvement in the performance of both models (CKD model: c-statistic 0.66 NRI 0.36 IDI 0.04, dialysis model: c-statistic 0.77 NRI 0.57 IDI 0.09). This was consistent after internal validation using bootstrapping and a sensitivity analysis excluding outcomes within the first 30 days.

CONCLUSION: Routinely collected screening metabolites at birth are associated with CKD and the need for dialytic therapies in infants and children, and add incremental information to traditional clinical risk factors.

Keywords: chronic kidney disease; dialysis; end-stage kidney disease; metabolomics; newborn screening; pediatric; renal failure

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