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Article: Differential Attention Functioning in Pediatric Chronic Kidney Disease.

Duquette, Peter J / Gipson, Debbie S / Hooper, Stephen R

2022 Volume 16, Page(s) 897131

Abstract: Objective: To compare specific attention functions for school-age children with chronic kidney disease (CKD) to those of a typically developing control group.: Methods: A cross-sectional study examined attention dimensions for children and ... ...

Abstract	Objective: To compare specific attention functions for school-age children with chronic kidney disease (CKD) to those of a typically developing control group. Methods: A cross-sectional study examined attention dimensions for children and adolescents with CKD ( Results: Significant group differences were revealed, with the CKD group performing worse than controls on the Focus/Execute, Sustain, and Encode dimensions. The CKD group also had a larger proportion of children with scores one standard deviation or more below the mean on the Shift and Encode domains, suggesting an at-risk level of functioning in these dimensions. Secondary analyses showed disease severity to be correlated with worse attention functions for children with CKD. Conclusion: Children with CKD may be vulnerable to subtle, specific deficits in numerous attention dimensions relative to their typically developing peers, particularly for those with more severe disease.
Language	English
Publishing date	2022-06-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2425477-0
ISSN	1662-5161
ISSN	1662-5161
DOI	10.3389/fnhum.2022.897131
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Article ; Online: Adult survivors of idiopathic childhood onset nephrotic syndrome.

Marchel, Dorota M / Gipson, Debbie S

Pediatric nephrology (Berlin, Germany)

2020 Volume 36, Issue 7, Page(s) 1731–1737

Abstract: Like many pediatric chronic health conditions, idiopathic childhood onset nephrotic syndrome (iCONS) and late effects of iCONS medical management may continue to impact the affected population in adulthood. Approximately 15% of adult survivors of steroid- ...

Abstract	Like many pediatric chronic health conditions, idiopathic childhood onset nephrotic syndrome (iCONS) and late effects of iCONS medical management may continue to impact the affected population in adulthood. Approximately 15% of adult survivors of steroid-sensitive iCONS continue to relapse. Long-term kidney health is associated with steroid response patterns as well as pathology findings of FSGS, tubulointerstitial fibrosis, tubular atrophy, and global glomerulosclerosis. Long-term cardiovascular disease burden is largely unknown in adult survivors, but risk factors starting in childhood, including hypertension, dyslipidemia, and obesity, are common in iCONS. Reproductive health concerns, including azo-/oligospermia and successful pregnancies, are largely related to prior exposure to cytotoxic therapies. Additional investigations are needed to complete the assessment and initiate the mitigation of the late effects of treatment-sensitive and treatment-resistant iCONS.
MeSH term(s)	Adult ; Child ; Disease Progression ; Glomerulosclerosis, Focal Segmental ; Humans ; Male ; Nephrosis, Lipoid ; Nephrotic Syndrome/drug therapy ; Nephrotic Syndrome/epidemiology ; Steroids ; Survivors
Chemical Substances	Steroids
Language	English
Publishing date	2020-11-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-020-04773-3
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Article ; Online: Artificial Intelligence in Pediatric Nephrology-A Call for Action.

Filler, Guido / Gipson, Debbie S / Iyamuremye, Didier / Díaz González de Ferris, Maria Esther

Advances in kidney disease and health

2022 Volume 30, Issue 1, Page(s) 17–24

Abstract: Artificial intelligence is playing an increasingly important role in many fields of clinical care to assist health care providers in patient management. In adult-focused nephrology, artificial intelligence is beginning to be used to improve clinical care, ...

Abstract	Artificial intelligence is playing an increasingly important role in many fields of clinical care to assist health care providers in patient management. In adult-focused nephrology, artificial intelligence is beginning to be used to improve clinical care, hemodialysis prescriptions, and follow-up of transplant recipients. This article provides an overview of medical artificial intelligence applications relevant to pediatric nephrology. We describe the core concepts of artificial intelligence and machine learning and cover the basics of neural networks and deep learning. We also discuss some examples for clinical applications of artificial intelligence in pediatric nephrology, including neonatal kidney function, early recognition of acute kidney injury, renally cleared drug dosing, intrapatient variability, urinary tract infection workup in infancy, and longitudinal disease progression. Furthermore, we consider the future of artificial intelligence in clinical pediatric nephrology and its potential impact on medical practice and address the ethical issues artificial intelligence raises in terms of clinical decision-making, health care provider-patient relationship, patient privacy, and data collection. This article also represents a call for action involving those of us striving to provide optimal services for children, adolescents, and young adults with chronic conditions.
MeSH term(s)	Adolescent ; Child ; Infant, Newborn ; Humans ; Artificial Intelligence ; Nephrology ; Neural Networks, Computer ; Machine Learning ; Renal Dialysis
Language	English
Publishing date	2022-12-13
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2949-8139
ISSN (online)	2949-8139
DOI	10.1053/j.akdh.2022.11.001
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Article ; Online: Improving the evidence for the management of childhood nephrotic syndrome.

Crawford, Brendan D / Gipson, Debbie S

Kidney international

2017 Volume 92, Issue 1, Page(s) 21–23

Abstract: Management of idiopathic nephrotic syndrome in children is based on a series of clinical trials. The trial by Sinha and colleagues in this issue is 1 of many needed to improve the evidence base for induction and maintenance therapies in this population. ... ...

Abstract	Management of idiopathic nephrotic syndrome in children is based on a series of clinical trials. The trial by Sinha and colleagues in this issue is 1 of many needed to improve the evidence base for induction and maintenance therapies in this population. While key questions remain about identifying the appropriate therapy for each patient, clinical trials provide an opportunity to extend evidence-based practice that minimizes toxicity and optimizes patient health.
Language	English
Publishing date	2017-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2017.02.029
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Article ; Online: Age- and Race-Specific Changes in ESKD Incidence over Four Decades.

Fwu, Chyng-Wen / Eggers, Paul W / Norton, Jenna M / Gipson, Debbie S / Kimmel, Paul L / Schulman, Ivonne H / Chan, Kevin E / Bennett, Kara / Mendley, Susan R

Journal of the American Society of Nephrology : JASN

2024 Volume 35, Issue 4, Page(s) 456–465

Abstract: Significance statement: ESKD incidence has changed substantially in the past four decades, but differences by age and race have been unexplored. Using data from the United States Renal Data System, we found that ESKD incidence rose for Black and White ... ...

Abstract	Significance statement: ESKD incidence has changed substantially in the past four decades, but differences by age and race have been unexplored. Using data from the United States Renal Data System, we found that ESKD incidence rose for Black and White teenagers, adults, and older adults for two decades beginning in 1980. Growth in incidence slowed for most groups by 1993, and by 2006, the annual percent change (APC) in ESKD incidence had declined for all groups, except White adults, for whom rates continued to rise. By 2019, ESKD incidence among Black and White adolescents nearly returned to 1980 levels, but no other group achieved that degree of improvement. Nonetheless, the ESKD incidence rate among Black American patients exceeds that of White patients in every age group. Distinct patterns in ESKD incidence among patients of different age, sex, and racial groups are shown. These findings could reflect changes in dialysis acceptance rates, access to preventive health care, incidence of diabetes mellitus, implementation of evidence-based guidelines for treatment of CKD, or other unrecognized factors. There may be population-specific opportunities to change the growth of the US ESKD population and address current racial disparities. Background: Substantial changes in ESKD incidence over four decades among Black and White Americans of different ages have been incompletely explored. Methods: We analyzed United States Renal Data System data from 1980 to 2019 to determine ESKD incidence trends among Black and White adolescent (13-17 years), adult (18-64 years), and older adult (≥65) populations. We used the National Cancer Institute Joinpoint Regression Program to estimate annual percent change (APC) in ESKD incidence and to define points in time where a statistically significant change in APC slope occurred for each group. Results: ESKD incidence rose after 1980 for all groups, although the trends differed ( P < 0.001). Growth in incidence slowed for most by 1993, and by 2006, the APC in ESKD incidence had declined for all groups, except White adults, for whom rates continued to rise ( P < 0.05). By 2019, ESKD incidence among Black and White adolescents nearly returned to 1980 levels, but no other group achieved that degree of improvement. Nonetheless, the ESKD incidence among Black American patients exceeds that of White patients in every age group. Conclusions: Distinct patterns in ESKD incidence among patients of different age, sex, and racial groups are shown. These findings could reflect changes in dialysis acceptance rates, access to preventive health care, incidence of diabetes mellitus, implementation of evidence-based guidelines for treatment of CKD, or other unrecognized factors. Podcast: This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN/2024_03_13_ASN0000000000000310.mp3.
MeSH term(s)	Adolescent ; Humans ; United States/epidemiology ; Aged ; Incidence ; Racial Groups ; Black or African American ; Diabetes Mellitus ; Renal Insufficiency, Chronic
Language	English
Publishing date	2024-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.0000000000000310
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Article ; Online: Pediatric contributions and lessons learned from the NEPTUNE cohort study.

Modi, Zubin J / Zhai, Yan / Yee, Jennifer / Desmond, Hailey / Hao, Wei / Sampson, Matthew G / Sethna, Christine B / Wang, Chia-Shi / Gipson, Debbie S / Trachtman, Howard / Kretzler, Matthias

Pediatric nephrology (Berlin, Germany)

2024

Abstract: Primary glomerular diseases are rare entities. This has hampered efforts to better understand the underlying pathobiology and to develop novel safe and effective therapies. NEPTUNE is a rare disease network that is focused on patients of all ages with ... ...

Abstract	Primary glomerular diseases are rare entities. This has hampered efforts to better understand the underlying pathobiology and to develop novel safe and effective therapies. NEPTUNE is a rare disease network that is focused on patients of all ages with minimal change disease, focal segmental glomerulosclerosis, and membranous nephropathy. It is a longitudinal cohort study that collects detailed demographic, clinical, histopathologic, genomic, transcriptomic, and metabolomic data. The goal is to develop a molecular classification for these disorders that supersedes the traditional pathological features-based schema. Pediatric patients are important contributors to this ongoing project. In this review, we provide a snapshot of the children and adolescents enrolled in NEPTUNE and summarize some key observations that have been made based on the data accumulated during the study. In addition, we describe the development of NEPTUNE Match, a program that aims to leverage the multi-scalar information gathered for each individual patient to provide guidance about potential clinical trial participation based on the molecular characterization and non-invasive biomarker profile. This represents the first organized effort to apply principles of precision medicine to the treatment of patients with primary glomerular disease. NEPTUNE has proven to be an invaluable asset in the study of glomerular diseases in patients of all ages including children and adolescents.
Language	English
Publishing date	2024-01-18
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-023-06256-7
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Article ; Online: Functional Magnetic Resonance Imaging Findings in Children and Adolescents With Chronic Kidney Disease: Preliminary Findings.

Harrell, Waverly / Gipson, Debbie S / Belger, Aysenil / Matsuda-Abedini, Mina / Bjornson, Bruce / Hooper, Stephen R

Seminars in nephrology

2021 Volume 41, Issue 5, Page(s) 462–475

Abstract: This cross-sectional study provides preliminary findings from one of the first functional brain imaging studies in children with chronic kidney disease (CKD). The sample included 21 children with CKD (ages, 14.4 ± 3.0 y) and 11 healthy controls (ages, 14. ...

Abstract	This cross-sectional study provides preliminary findings from one of the first functional brain imaging studies in children with chronic kidney disease (CKD). The sample included 21 children with CKD (ages, 14.4 ± 3.0 y) and 11 healthy controls (ages, 14.5 ± 3.4 y). Using functional magnetic resonance imaging during a visual-spatial working memory task, findings showed that the CKD group and healthy controls invoked similar brain regions for encoding and retrieval phases of the task, but significant group differences were noted in the activation patterns for both components of the task. For the encoding phase, the CKD group showed lower activation in the posterior cingulate, anterior cingulate, precuneus, and middle occipital gyrus than the control group, but more activation in the superior temporal gyrus, middle frontal gyrus, middle temporal gyrus, and the insula. For the retrieval phase, the CKD group showed underactivation for brain systems involving the posterior cingulate, medial frontal gyrus, occipital lobe, and middle temporal gyrus, and greater activation than the healthy controls in the postcentral gyrus. Few group differences were noted with respect to disease severity. These preliminary findings support evidence showing a neurologic basis to the cognitive difficulties evident in pediatric CKD, and lay the foundation for future studies to explore the neural underpinnings for neurocognitive (dys)function in this population.
MeSH term(s)	Adolescent ; Brain/diagnostic imaging ; Child ; Cross-Sectional Studies ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Renal Insufficiency, Chronic/diagnostic imaging
Language	English
Publishing date	2021-12-06
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
DOI	10.1016/j.semnephrol.2021.09.009
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Article ; Online: The Health Economic Impact of Nephrotic Syndrome in the United States.

Simon, Christine A / Salmon, Eloise / Desmond, Hailey E / Massengill, Susan F / Gipson, Wilson P / Gipson, Debbie S

Kidney360

2022 Volume 3, Issue 6, Page(s) 1073–1079

Abstract: Background: Nephrotic syndrome (NS) is a rare kidney syndrome with high morbidity. Although a common contributor to the burden of chronic kidney disease, the direct and indirect costs of NS to patients and family caregivers are unrecognized. The ... ...

Abstract	Background: Nephrotic syndrome (NS) is a rare kidney syndrome with high morbidity. Although a common contributor to the burden of chronic kidney disease, the direct and indirect costs of NS to patients and family caregivers are unrecognized. The objective was to characterize the direct and indirect costs of NS to patients. Methods: Adults with NS and family caregivers of children with NS were eligible to participate if they had a diagnosis of primary NS, had disease for at least 1 year, and had no other severe health conditions. Data-collection surveys were generated with input from the Kidney Research Network Patient Advisory Board, and surveys were mailed to the eligible participants. Participants were provided $50 for the return of completed surveys. Costs were defined as either direct out-of-pocket costs or indirect costs ( Results: Respondents included 28 adult patients and 17 caregivers of patients who were minors. Reported health insurance coverage included 35 (78%) with private insurance, 12 (27%) with public insurance, six (13%) with Children's Special Health Care Services, and one (2%) uninsured. Median annual direct costs were $3464 ($844-$5865) for adult patients and $1687 (IQR $1035-$4763) for caregivers. Of these costs, diet-associated costs contributed $1140 (IQR $600-$2400). The most substantial indirect cost was from the time spent planning/prepping meals (adults: 183 h/yr [IQR 114-331]; caregivers: 173 h/yr [IQR 84-205]). Conclusions: Adults and caregivers of children with NS face substantial disease-related direct and indirect costs beyond those covered by insurance. Following replication, the study will help health care providers, systems, and payers gain a better understanding of the financial and time burden incurred by those living with NS, consider barriers when treating patients, and develop supportive strategies.
MeSH term(s)	Adult ; Caregivers ; Child ; Health Expenditures ; Health Services ; Humans ; Medically Uninsured ; Nephrotic Syndrome ; United States/epidemiology
Language	English
Publishing date	2022-04-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2641-7650
ISSN (online)	2641-7650
DOI	10.34067/KID.0005072021
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Article ; Online: Matching the Genotype in Resolution: Innovative Ways of Phenotype Capture.

Hicken, Margaret T / Gipson, Debbie S

Seminars in nephrology

2015 Volume 35, Issue 3, Page(s) 279–290

Abstract: Social and spatial context are important determinants of morbidity and mortality. However, there is little clarity about the role of context for kidney disease specifically, particularly before the end stage. Meanwhile, research clarifying the clinical, ... ...

Abstract	Social and spatial context are important determinants of morbidity and mortality. However, there is little clarity about the role of context for kidney disease specifically, particularly before the end stage. Meanwhile, research clarifying the clinical, cellular, molecular, and genetic causes of kidney disease is accelerating considerably. We postulate that without contextual information, even the most detailed biomedical information cannot fully capture the factors that ultimately drive the development and progression of kidney disease. The Nephrotic Syndrome Study Network is integrating detailed, state-of-the-art information on a social and spatial context to enable the exploration of the associations between the social environment and kidney disease. Here, we discuss the extant literature on social context and kidney disease, present information on sources of contextual information, and provide recommended further reading to facilitate future research on the contribution of the social context to kidney disease.
MeSH term(s)	Disease Progression ; Genotype ; Global Health ; Health Status Disparities ; Humans ; Morbidity/trends ; Nephrotic Syndrome/diagnosis ; Nephrotic Syndrome/epidemiology ; Nephrotic Syndrome/genetics ; Phenotype ; Socioeconomic Factors
Language	English
Publishing date	2015-07-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
DOI	10.1016/j.semnephrol.2015.04.007
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Article ; Online: Inpatient Pediatric CKD Health Care Utilization and Mortality in the United States.

Modi, Zubin J / Waldo, Anne / Selewski, David T / Troost, Jonathan P / Gipson, Debbie S

American journal of kidney diseases : the official journal of the National Kidney Foundation

2020 Volume 77, Issue 4, Page(s) 500–508

Abstract: Rationale & objective: The impact of chronic kidney disease (CKD) on inpatient health care use is unknown. This study aimed to describe the prevalence of pediatric CKD among children hospitalized in the United States and examine the association of CKD ... ...

Abstract	Rationale & objective: The impact of chronic kidney disease (CKD) on inpatient health care use is unknown. This study aimed to describe the prevalence of pediatric CKD among children hospitalized in the United States and examine the association of CKD with hospital outcomes. Study design: Cross-sectional national survey of pediatric discharges. Setting & participants: Hospital discharges of children (aged>28 days to 19 years) with a chronic medical diagnosis included in the Healthcare Cost and Utilization Project Kids' Inpatient Database for 2006, 2009, 2012, and 2016. Predictor: Presence of primary or coexisting CKD as identified by diagnosis codes. Outcomes: Length of stay (LOS), cost, and mortality. Analytical approach: Multivariable analysis using Poisson, gamma, and logistic regressions were performed for LOS, cost, and mortality, respectively. Results: A chronic medical condition was present in 6,524,745 estimated discharges during the study period and CKD was present among 3.9% of discharges (96.1% without CKD). Those with CKD had a longer LOS (median of 2.8 [IQR, 1.4-6.0] days compared with 1.8 [IQR, 1.0-4.4] days for those without a CKD diagnosis; P<0.001). Median cost was higher in the CKD group compared with the group without CKD, at $8,755 (IQR, $4,563-18,345) and $5,016 (IQR, $2,860-10,109) per hospitalization, respectively (P<0.001). Presence of CKD was associated with a longer LOS (29.9% [95% CI, 27.2%-32.6%] longer than those without CKD), higher cost (61.3% [95% CI, 57.4%-65.4%] greater than those without CKD), and higher risk for mortality (OR, 1.51 [95% CI, 1.40-1.63]). Limitations: Lack of access to and adjustment for confounders including patient readmission and laboratory data. Conclusions: Pediatric CKD was associated with longer LOS, higher costs, and higher risk for mortality compared with hospitalizations with other chronic illnesses. Further studies are needed to better understand the health care needs and delivery of care to hospitalized children with CKD.
MeSH term(s)	Child ; Cohort Studies ; Cross-Sectional Studies ; Databases, Factual/trends ; Female ; Hospitalization/trends ; Humans ; Male ; Patient Acceptance of Health Care ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/therapy ; United States/epidemiology
Language	English
Publishing date	2020-10-12
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	604539-x
ISSN	1523-6838 ; 0272-6386
ISSN (online)	1523-6838
ISSN	0272-6386
DOI	10.1053/j.ajkd.2020.07.024
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