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Overview of the management of chronic kidney disease in children

Authors
Tarak Srivastava, MD
Bradley A Warady, 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, which can be progressive. CKD 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 kidney dysfunction of varying degrees from severe to mild in nature. CKD more clearly defines kidney dysfunction as a continuum, rather than a discrete change in kidney function, and will be used throughout this topic review.

An overview of the management of CKD in children will be reviewed here. The etiology, epidemiology, natural course, presentation, and evaluation of CKD in children are discussed separately. (See "Epidemiology, etiology, and course of chronic kidney disease in children" and "Clinical presentation and evaluation of chronic kidney disease in children".)

DEFINITIONS

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. (See "Epidemiology, etiology, and course of chronic kidney disease in children", section on 'Definitions and classifications'.)

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: Wed May 25 00:00:00 GMT 2016.
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