TOPLINE:

Patients with Down syndrome had a substantially higher risk for acute kidney injury (AKI) and chronic kidney disease (CKD) than control individuals from the general population.

METHODOLOGY:

• Researchers conducted a nationwide registry-based cohort study to compare the cumulative incidence of AKI and CKD across the lifespan in 2815 patients with Down syndrome with that in 28,150 age- and sex-matched control individuals from the general population.
• The index date was defined as the date when a person had lived for at least 1 year in a municipality with complete laboratory records, ensuring that the laboratory results needed to identify potential outcomes were available; at the index date, the median age of patients with Down syndrome was 24 years, and 46% were women.
• Laboratory data on plasma creatinine measurements were utilised to assess AKI and CKD. AKI and CKD were defined in accordance with international Kidney Disease: Improving Global Outcomes guidelines.

TAKEAWAY:

• Patients with Down syndrome had a substantially higher incidence of AKI than control individuals at ages of 20 years (28.9% vs 1.4%), 40 years (32.8% vs 5.3%), and 70 years (48.6% vs 23.8%).
• Similarly, they had a markedly higher incidence of CKD than control individuals at ages of 20 years (1.2% vs 0.1%), 40 years (3.9% vs 0.4%), and 70 years (23.2% vs 13.8%).
• This elevated incidence of both AKI and CKD in patients with Down syndrome persisted even after excluding those with congenital heart disease.
• Mortality was also higher in patients with Down syndrome than in control individuals throughout the lifespan.

IN PRACTICE:

"By recognizing the higher risk of kidney disease in individuals with DS [Down syndrome], clinicians can work toward developing and testing targeted surveillance programs and individualized treatment plans," the authors wrote.

SOURCE:

This study was led by Freja Leonore Uhd Weldingh, Aarhus University Hospital, Aarhus, Denmark. It was published online on December 23, 2025, in Clinical Kidney Journal.

LIMITATIONS:

This study lacked laboratory data for the earliest years, which may have introduced selection bias. Additionally, the analysis of AKI in children with Down syndrome relied on a small subpopulation, so the risk estimates were less precise.

DISCLOSURES:

This study was supported by Aarhus University's Research Foundation through a research year scholarship granted to the investigator. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.