TY  - CHAP
M1  - Book, Section
TI  - Chronic Kidney Disease
A1  - Srivaths, Poyyapakkam
A2  - Kline, Mark W.
Y1  - 2018
N1  - 
T2  - Rudolph's Pediatrics, 23e
AB  - Chronic  kidney  disease  (CKD)  is  defined  as  abnormalities  of  kidney  structure  or  function  present  for  ≥  3  months.  The  chief  markers  of  kidney  damage  include  either  decreased  glomerular  filtration  rate  (GFR)  <  60  mL/min/1.73  m2  or  albuminuria.  Additional  markers  are  the  presence  of  urine  sediment  abnormalities,  electrolyte  disturbances  due  to  tubular  disorder,  abnormalities  detected  either  by  imaging  or  kidney  biopsy,  or  a  history  of  kidney  transplantation.  In  addition,  a  defined  staging  system  has  evolved  to  classify  the  severity  of  CKD  and  guide  clinical  management,  as  certain  manifestations  and  complications  of  CKD  arise  at  specific  GFR  levels  irrespective  of  the  etiology  of  CKD.  In  2012,  Kidney  Disease  Improving  Global  Outcome  (KDIGO)  guidelines  modified  this  staging  system  to  include  albuminuria,  as  the  relative  risk  of  mortality,  cardiovascular  complications,  and  disease  progression  is  influenced  independently  by  both  GFR  and  albuminuria  (Table  473-1).  There  are  a  number  of  caveats  with  respect  to  applying  this  classification  system  to  pediatrics.  First,  the  staging  of  CKD  excludes  patients  younger  than  2  years  whose  renal  function  improves  markedly  in  the  first  2  years  of  life;  therefore,  a  GFR  <  90  mL/min/1.73  m2  in  a  6-month-old  child  may  not  represent  any  abnormality  of  renal  function.  Second,  the  duration  of  ≥  3  months  to  define  CKD  cannot  be  applied  to  newborns  and  infants  younger  than  3  months  of  age.  Finally,  in  children,  urinary  protein  excretion  can  be  used  instead  of  albumin  excretion.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1182913171
ER  -