Chronic kidney disease (CKD) in children has a significant impact on morbidity, mortality, and quality of life. The degree of renal dysfunction should be calculated using pediatric-specific formulas and the degree of CKD staged; this allows for appropriate dosing of medications based on renal function and monitoring for progression and comorbid conditions including metabolic acidosis, bone disease, anemia, cardiovascular complications, malnutrition and electrolyte abnormalities, growth failure, and psychosocial issues. Treatment strategies include treating the underlying disease and using general renal protective measures. Effective management of these complex issues requires a specialized multidisciplinary team approach.
General renal protective measures, such as avoiding potential nephrotoxic agents, effectively treating high blood pressure, and avoiding excessive protein supplementation, should be used in all children with chronic kidney disease.
Central lines and peripherally inserted central lines should be avoided in children with advanced stage chronic kidney disease.
Based on the stage of chronic kidney disease, comorbid conditions should be anticipated and appropriately treated, including metabolic acidosis, bone disease, anemia, cardiovascular complications, malnutrition and electrolyte abnormalities, growth failure, and psychosocial issues.
Effective management of children with chronic kidney disease requires a specialized multidisciplinary team approach.
Pediatric chronic kidney disease (CKD) is a complex disorder that has a lifelong impact and is associated with a decreased quality of life [
]. Potential adverse outcomes of CKD can be delayed or prevented by early identification and treatment. Common causes of CKD in childhood ( Table 1 ) vary by age, race, and geography. Congenital abnormalities of the kidneys and urinary tract are the most common cause of CKD in younger children. The incidence of glomerulonephritis increases with age [ ]. Identifying and appropriately treating the underlying cause is essential to preventing or delaying the progression of the CKD.