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Chronic Kidney Disease, Pediatric

Rebecca L. Ruebner, MD, MSCE and Madhura Pradhan, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • The Kidney Disease: Improving Global Outcomes (KDIGO) 2012 clinical practice guideline defines pediatric chronic kidney disease (CKD) based on a child meeting one of the following cr...

DIAGNOSIS

HISTORY

  • Past history

    • Birth history for oligohydramnios, perinatal events

    • Recurrent urinary tract infections (UTIs)

    • Enuresis

    • Abnormal urinary stream (PUV)

  • Family history

    • CKD, dialysis, kidney transp...

TREATMENT

GENERAL MEASURES

  • Avoid nephrotoxic medications including NSAIDs.

  • Fluid restriction may be necessary in patients with glomerular disease.

  • Monitor BP closely and initiate therapy for patients wit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Children with CKD need close outpatient follow-up every 1 to 3 months, depending on the level of GFR to monitor BP, growth, and lab tests. 

DIET

R...

ADDITIONAL READING

  • Friedman AL. Etiology, pathophysiology, diagnosis, and management of chronic renal failure in children. Curr Opin Pediatr.  1996;8(2):148–151. [View Abstract on OvidInsights]

  • Ki...

CODES

ICD9

  • 585.9 Chronic kidney disease, unspecified

  • 753.3 Other specified anomalies of kidney

  • 585.3 Chronic kidney disease, Stage III (moderate)

  • 753.15 Renal dysplasia

  • 585.5 Chronic kidney disease, Stage ...

FAQ

  • Q: Which OTC medications should be avoided in children with CKD?

  • A: NSAIDs, pseudoephedrine (if patient is hypertensive), enemas containing phosphate, and antacids containing magnesium or aluminum ...

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