McLeod DJ, et al. - Researchers assessed the ability of clinically available markers to predict end-stage renal disease (ESRD) in children with obstructive uropathy (OU) identified in the Chronic Kidney Disease in Children Study. Renal replacement therapy (RRT) (cases) was the primary outcome of interest and age matched controls included patients within the OU cohort who did not require RRT during study follow-up. Participants included 27 cases and 41 age-matched controls, with median age at baseline and age at outcome measurement were 10 vs 16 years, respectively. Comparison of cases and controls revealed significantly differed first available glomerular filtration rate (GFR) (36.9 vs 53.5 mL/min per 1.73 m²), urine protein/creatinine (Cr) (0.40 vs 0.22 mg/mg) and microalbumin/Cr (0.58 vs 0.03 mg/mg), and serum CO₂ (20 vs 22 mmol/L) and hemoglobin (12.4 vs 13.2 g/dL), respectively. A 3.07 mL/min per 1.73 m²/year faster GFR decline was observed among cases vs controls. Urine protein/Cr and microalbumin/Cr increased by 0.16 and 0.11 per year more in cases vs those in controls, respectively. For cases vs for controls, a greater increase in serum phosphate by 0.11 mg/dL and more decrease in serum albumin and hemoglobin by 0.04 (g/dL) and 0.14 (g/dL) per year were observed, respectively. Overall, progression to ESRD in children with mild-to-moderate CKD from OU was predicted by age-specific baseline and longitudinal measures of readily available clinical measures.