Long-Term Kidney Outcomes in Children and Adolescents with Hypertension
Bibliographic record
Abstract
Background: Hypertension affects 6% of all children and its prevalence is increasing. Pediatric hypertension has been associated with elevated risks of all-cause mortality and cardiovascular events among children and adults. In children with chronic kidney disease, hypertension is associated with progression to kidney failure. However, in those with no prior kidney diseasedirect evidence linking pediatric hypertension, with long-term kidney outcomes is limited. We aim to determine the long-term risks of developing chronic kidney disease and kidney failure among children with hypertension. Methods: Population-based retrospective cohort study of all children (ages 3-18 years) diagnosed with hypertension from 1996 to 2021 in Ontario, Canada, using validated case definitions in health administrative databases. Each case was propensity score-matched with five normotensive controls by age, sex, birthweight, maternal gestational hypertension, prior diabetes mellitus, cardiovascular surgery, and a propensity score for hypertension diagnosis. Primary outcomes were incident stage 3 chronic kidney disease and end-stage kidney disease (initiation of chronic dialysis, or receipt of kidney transplant). Results: A total of 25,605 children and adolescents with hypertension were matched to 128,025 controls without hypertension. Children were followed until death(0.7%), emigration from Ontario(11.2%), or study end(88.1%). Median age was 15 years[IQR 11-17], 49% were female, and prior comorbidities were uncommon(1% had congenital heart disease, 1.7% malignancy, 0.4% diabetes). During a median of 12.9 years[IQR 6.8-19.9) of follow up, the incidence rate(IR) of chronic kidney disease was 4.84/1000 person-years(py) in children with hypertension vs 0.42/1000py in controls (adjusted hazard ratio(aHR) 5.9, 95% CI 5.5-6.4). Children with hypertension were also at increased risk of end-stage kidney disease (IR 1.11 vs 0.03/1000py; aHR 9.6, 95% CI 7.8-11.9) compared to controls. Conclusion: Children and adolescents diagnosed with hypertension are at higher long-term risks of chronic kidney disease and kidney failure, compared to non-hypertensive controls. Improved pediatric hypertension recognition and control may prevent progressive kidney function decline. These findings should be confirmed by large-scale, well controlled prospective studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".