Epidemiology, etiology, and course of chronic kidney disease in children
- Craig S Wong, MD
Craig S Wong, MD
- Associate Professor, Department of Pediatrics
- University of New Mexico
- Bradley A Warady, MD
Bradley A Warady, MD
- Professor of Pediatrics
- University of Missouri-Kansas City School of Medicine
Chronic kidney disease (CKD) refers to a state of irreversible kidney damage and/or reduction of kidney function that can lead to a future decrease in kidney function. The term CKD defines renal dysfunction as a continuum, rather than a discrete change in renal function, and will be used throughout this topic review.
CKD in children is caused by a variety of congenital and acquired kidney disorders. The etiology and epidemiology of CKD in children will be reviewed here. The clinical presentation, evaluation, and management of CKD in children are discussed separately. (See "Clinical presentation and evaluation of chronic kidney disease in children" and "Overview of the management of chronic kidney disease in children".)
DEFINITIONS AND CLASSIFICATIONS
KDIGO pediatric definition — 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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