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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Paediatric Chronic Kidney Disease (pCKD) is associated with progressive cardiovascular, growth and neurocognitive complications. Unlike adult CKD, which often stems from diabetes or hypertension, pCKD is largely driven by congenital anomalies of the kidney and urinary tract and hereditary nephropathies. These causes account for up to two-thirds of cases, underscoring the need for early identification of high-risk children for timely interventions. While the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend urinary albumin-to-creatinine ratio (UACR) and protein-to-creatinine ratio (UPCR) to assess CKD progression, their relative prognostic value in children, although well established in adults, remains unclear. This study compared the prognostic performance of UACR and UPCR for end-stage kidney disease (ESKD) and estimated glomerular filtration rate (eGFR) decline in pCKD.
We analysed 674 children aged 6–17 years with CKD stages 3–5 enrolled in a European multicentre 4C study (NCT01046448). Baseline UACR and UPCR (mg/g) were log10-transformed and Z-standardised. The primary outcome was time to ESKD (dialysis, transplantation, CKD5, or 50% sustained eGFR loss). The secondary outcome was annual eGFR slope over a five-year period. Covariate-adjusted Cox proportional hazards and linear mixed-effects models (LMM) quantified associations per 1-SD increase in the standardised log10-transformed biomarker, adjusting for age, sex, CKD cause, baseline eGFR, and mean arterial pressure. Prognostic strength was compared using bootstrap-based bias-corrected and accelerated 95% confidence intervals(CIs).
Median age at baseline was 12.4 years (IQR 9.6–15.0); 34% were female, and 69% had CAKUT. Median baseline eGFR was 27 (IQR 20–35) mL/min/1.73m2, and median baseline UACR and UPCR were 359 (IQR 91–1232) mg/g and 1317 (IQR 570–3.065) mg/g, respectively. With a median follow-up of 2.2 years (IQR 0.8–4.6), 383 ESKD events occurred. Each 1-SD increase in log10-UACR and log10-UPCR was associated with 2.05-fold (95% CI 1.76–2.38) and 1.63-fold (95% CI 1.47–1.81) higher ESKD risk, respectively, with UACR showing a 25% stronger prognostic effect (HR UACR:UPCR 1.25; 95% CI 1.10–1.49). Both biomarkers were independently associated with faster eGFR decline (–0.86 vs. –0.79 mL/min/1.73 m2/year), with no significant difference between them (∆ = –0.06; 95% CI –0.45 to 0.20). Subgroup analysis showed consistent associations across age, sex, CKD causes, and baseline eGFR, with UACR demonstrating the most significant prognostic advantage in children with advanced CKD and heavy proteinuria.
Both UACR and UPCR were independently associated with ESKD risk and faster eGFR decline in pCKD. Compared to UPCR, UACR had a superior prognostic value for ESKD risk and a stronger association with eGFR decline, especially in children with advanced pCKD or severe proteinuria. These findings confirm UACR as the most sensitive and clinically informative biomarker for risk stratification, disease monitoring, and treatment planning in pCKD.
