Headache in Pediatric and Adolescent Patients with Chronic Kidney Disease and after Kidney Transplantation – A Comparative Study

Aim: This study compared prevalence and characteristics of headaches between pediatric patients with chronic kidney disease and pediatric patients with transplanted kidneys; and aimed to identify factors associated with headaches in the entire cohort.

Methods: We interviewed 87 children and adolescents with either chronic kidney disease or transplanted kidney in a pediatric nephrology institute, regarding the prevalence of headaches and their characteristics. We reviewed hospital charts for medical history, blood test results and pharmacologic treatment.

Results: Twenty-two patients (25.3%) reported experiencing headaches, of them 15 (68%) had migraine. The prevalence was greater among those with chronic kidney disease than among those after kidney transplant: 36.6% vs 15.2%, p=0.03 OR 3.21, 95% CI 1.04-10.54, For the entire cohort, headache, mostly migraine, was associated with lower glomerular filtration, higher phosphate level and a higher, though not statistically significant, urea level.

Conclusions: In a pediatric population, headaches were less prevalent among patients after kidney transplantation than among patients with chronic kidney disease. Headache was associated with a lower glomerular filtration rate, a higher phosphate level and a higher level, though without statistical significance, of urea. The lower headache rate after kidney transplantation may be related to improvement in homeostasis and electrolyte balance.