Evidence map›Paper›PMID 39928602›Full record

ArticlePloS one2025

Identifying children who develop severe chronic kidney disease using primary care records.

Lucy Plumb, Manish D Sinha, Timothy Jones, M Theresa Redaniel, Matthew J Ridd, Amanda Owen-Smith, Fergus J Caskey, Yoav Ben-Shlomo

Abstract read
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lucy PlumbPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.ORCID 0000-0002-3873-8567
Manish D SinhaDepartment of Paediatric Nephrology, Evelina London Children's Hospital, London, United Kingdom.
Timothy JonesPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.ORCID 0000-0002-1199-8668
M Theresa RedanielPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.
Matthew J RiddPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.
Amanda Owen-SmithPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.
Fergus J CaskeyPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.ORCID 0000-0002-5199-3925
Yoav Ben-ShlomoPopulation Health Sciences, University of Bristol Medical School, Bristol, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnderstanding whether symptoms suggestive of chronic kidney disease (CKD) are reported to primary care before diagnosis may provide opportunities for earlier detection, thus supporting strategies to prevent progression and improve long-term outcomes. Our aim was to determine whether symptoms/signs or consultation frequency recorded in primary care could predict a subsequent diagnosis of chronic kidney disease in children.

methodsWe undertook a case-control study within Clinical Practice Research Datalink. Cases were children <21 years with an incident code for severe CKD during the study period (January 2000-September 2018). Controls were matched on age (+/-3 years), sex, and practice-level kidney function testing rate. Conditional logistic regression modelling was used to identify symptoms predictive of severe CKD and differences in consultation frequency in 24- and 6-month timeframes before the index date.

resultsSymptoms predictive of severe CKD in the 24 months before the index date included growth concerns (OR 7.4, 95% CI 3.5, 15.4), oedema (OR 5.7, 95% CI 2.9, 11.2) and urinary tract infection (OR 3.3, 95% CI 2.1, 5.4); within 6 months of the index date, effect estimates and specificity strengthened although sensitivity decreased. Overall, positive predictive value of symptoms was low. Cases consulted more frequently than controls in both timeframes. In combination, symptoms and consultation frequency demonstrated modest discrimination for CKD (c-statistic after bootstrapping 0.70, 95% CI 0.66, 0.73).

conclusionDespite increased consultation frequency and several symptoms being associated with severe chronic kidney disease, the positive predictive value of symptoms is low given disease rarity making earlier diagnosis challenging.

Indexed as

Primary Health CareRenal Insufficiency, ChronicAdolescentCase-Control StudiesChildChild, PreschoolFemaleHumansInfantMaleSeverity of Illness IndexYoung Adult

Identifiers

PMID39928602
PMCPMC11809798

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.