Chronic kidney disease in children

Abstract

Chronic kidney disease (CKD) is a major health problem worldwide. Although relatively uncommon in children, it can be a devastating illness with many long-term consequences. CKD presents unique features in childhood and may be considered, at least in part, as a stand-alone nosologic entity. Moreover, some typical features of paediatric CKD, such as the disease aetiology or cardiovascular complications, will not only influence the child's health, but also have long-term impact on the life of the adult that they will become. In this review we will focus on the unique issues of paediatric CKD, in terms of aetiology, clinical features and treatment. In addition, we will discuss factors related to CKD that start during childhood and require appropriate treatments in order to optimize health outcomes and transition to nephrologist management in adult life.

How to grow up with chronic kidney disease?

“…An inherited predisposition for CKD progression may be in the form of monogenetic mutations, single nucleotide polymorphisms, and epigenetic modifications of the genome (DNA methylation, histone modification, or RNA interference) influenced by environmental factors (26). Nowadays, more than 200 genes are clearly recognized as causative of the most common etiological categories of CKD in children (CAKUT, steroid resistant nephritic syndrome, and ciliopathies) (27).…”

Off‐label use of tacrolimus in children with glomerular disease: Effectiveness, safety and pharmacokinetics

“…Glomerular disease is a common cause of kidney disease in children . If it cannot be treated or controlled quickly and effectively, it can develop into chronic renal insufficiency, which is the one of the main causes of irreversible end‐stage renal disease (ESRD) and seriously endangers children's health …”

“…6 If it cannot be treated or controlled quickly and effectively, it can develop into chronic renal insufficiency, which is the one of the main causes of irreversible end-stage renal disease (ESRD) and seriously endangers children's health. 7,8 The uniquely strengthening and maturing immune system during childhood may require age-specific approaches to disease management. 9 In paediatric clinical practice, off-label use of tacrolimus is also a common issue.…”

Serum creatinine levels in relationship with mean platelet volume in patients with chronic kidney disease

“…On the other hand, cardiovascular disease and stroke are the most important complications of CKD (2,3). Evaluation of GFR is the best indicator of renal function.…”