A retrospective study of renal complications and kidney function in children with Down syndrome at a single institution

BACKGROUND AND PURPOSE: This study aimed to clarify the status of renal complications and kidney function in children with Down syndrome (DS). METHODS: We retrospectively reviewed medical records of patients with DS aged < 15 years who visited our hospital between January 2011 and December 2024. Children lacking serum creatinine (S-Cr) measurements after 3 months of age or height data for calculation of estimated glomerular filtration rate (eGFR) were excluded. RESULTS: Seventy-six children with DS (43 boys, 33 girls) were included. Mild hydronephrosis and voiding dysfunction were observed in two (2.6%) patients each. The median S-Cr level ranged from 0.26 to 0.28 mg/dL across age groups from 3 months to < 2 years, and it was slightly higher than the reported reference values for healthy children. The mean eGFR in children aged 2 to 18 years was 93.03±11.5 mL/min/1.73 m2. Low birth weight (LBW) was significantly associated with a reduced eGFR (p=0.02; odds ratio: 2.44, 95% confidence interval: 1.14–2.32). Although prematurity was slightly correlated with eGFR (p=0.048), its confidence interval (0.98–4.56) included the null value. No significant difference in eGFR was observed in children with hypothyroidism or congenital heart disease. CONCLUSION: Careful monitoring of S-Cr levels and eGFR appears to be particularly beneficial in children with DS, especially those born with LBW or prematurely. Clarification of risk factors and establishment of appropriate renal assessment methods in this population are required.