Chronic Kidney Disease

Abstract

Congenital anomalies of kidney and the urinary tract constitute the commonest cause of chronic kidney disease (CKD) in children. The incidence and prevalence of CKD in children is underreported because of lack of symptoms in initial stages of the disease, though increased use of antenatal ultrasonography is helping diagnose more patients before they become symptomatic. Growth failure in pre-pubertal children with CKD is a common complication. Nutritional management is, therefore, critically important and this often involves gavage feeding in younger children. Those with persistent growth failure also need recombinant growth hormone administration. Long-term renal replacement therapy for end-stage kidney disease (ESKD) is possible even in babies and infants. Kidney transplantation significantly improves the life expectancy of ESKD patents. A multidisciplinary team that includes psychosocial support is essential for the management of children with advanced CKD.