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Clinical presentation and evaluation of chronic kidney disease in children

Authors
Craig S Wong, MD
Bradley A Warady, MD
Tarak Srivastava, MD
Section Editor
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD

INTRODUCTION

Chronic kidney disease (CKD) refers to a state of irreversible kidney damage and/or reduction of kidney function that can lead to a progressive decrease in kidney function. It is now the accepted term in the pediatric nephrology community, replacing the clinical terms of chronic renal failure (CRF) and chronic renal insufficiency (CRI), which describe renal dysfunction of varying degrees from severe to mild in nature. CKD more clearly defines renal dysfunction as a continuum, rather than a discrete change in renal function, and will be used throughout this topic review.

The clinical manifestations, diagnosis, and evaluation of CKD in children will be reviewed here. The etiology, epidemiology, natural course, and management of CKD in children are discussed separately. (See "Epidemiology, etiology, and course of chronic kidney disease in children" and "Overview of the management of chronic kidney disease in children".)

DEFINITIONS AND DIAGNOSIS

The Kidney Disease: Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline (CPG) for Evaluation and Management of Chronic Kidney Disease revised the 2002 classification of pediatric chronic kidney disease (CKD) by the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Chronic Kidney Disease [1,2]. The KDIGO classification includes etiology, renal function based on glomerular filtration rate (GFR), and the presence and rate of albumin urinary excretion.

The KDIGO diagnosis of pediatric CKD is based on fulfilling one of the following clinical criteria:

GFR of less than 60 mL/min per 1.73 m2 for greater than three months with implications for health regardless of whether other CKD markers are present.

                                  

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Literature review current through: Nov 2016. | This topic last updated: Tue Oct 11 00:00:00 GMT+00:00 2016.
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