RT Book, Section A1 Chase, Lindsay A2 Zaoutis, Lisa B. A2 Chiang, Vincent W. SR Print(0) ID 1146119731 T1 Chronic Renal Failure T2 Comprehensive Pediatric Hospital Medicine, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071829281 LK accesspediatrics.mhmedical.com/content.aspx?aid=1146119731 RD 2024/11/05 AB Chronic renal failure (CRF) is an irreversible reduction in renal function, or glomerular filtration rate (GFR), with accompanying derangements in biochemical homeostasis. The term chronic kidney disease (CKD) incorporates CRF and chronic renal insufficiency, which are considered part of the spectrum of CKD. End-stage renal disease (ESRD) is defined as CRF so severe that a form of renal replacement therapy (such as peritoneal dialysis) is required. The Kidney Disease Outcomes Quality Initiative of the National Kidney Foundation established standards for the definition and classification of CKD to promote early diagnosis (Table 111-1)1. These standards define CKD as being present in any patient who meets one of two criteria: (1) there is evidence of kidney damage for 3 months or more, as defined by structural abnormalities of the kidney with or without decreased GFR, as evidenced by abnormalities in the composition of blood or urine, abnormalities in imaging tests, or abnormalities on kidney biopsy; (2) the GFR is less than 60 mL/minute per 1.73 m2 for 3 months or more, with or without any structural changes. GFR is not adequately determined using serum creatinine alone; it should be estimated using a prediction equation such as the Schwartz equation (Table 111-3)2.