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 2024/04/24
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.