Chronic Kidney Disease (CKD)

Pediatric Chronic Kidney Disease (CKD) refers to a long-term and usually irreversible reduction in kidney function that persists for three months or more. It affects the body’s ability to filter waste, balance fluids and electrolytes, and regulate blood pressure and red blood cell production. Early detection and intervention are critical to slow disease progression and improve outcomes.

CKD in children can be classified based on cause (e.g., congenital vs. acquired), glomerular filtration rate (GFR), and the presence of albuminuria. Common types include:

• Congenital anomalies of the kidney and urinary tract (CAKUT)
• Hereditary nephropathies (e.g., Alport syndrome)
• Glomerular diseases (e.g., focal segmental glomerulosclerosis, lupus nephritis)
• Obstructive uropathy
• Chronic infections or reflux nephropathy

Early stages may have no noticeable symptoms. As kidney function declines, children may show:

• Fatigue or poor concentration
• Loss of appetite, nausea, or vomiting
• Growth delay or short stature
• Swelling in the face, abdomen, or limbs (edema)
• Increased or decreased urination
• High blood pressure
• Pale skin or anemia-related symptoms

• Congenital structural abnormalities (e.g., CAKUT)
• Genetic disorders (e.g., polycystic kidney disease, Alport syndrome)
• Glomerular diseases
• Recurrent urinary tract infections or obstruction
• Nephrotoxic medications

• Family history of kidney disease
• Premature birth or low birth weight
• Systemic diseases (e.g., lupus)
• Obesity, hypertension, or diabetes

While not all causes are preventable, CKD progression can be delayed by:

• Early detection through routine check-ups
• Good control of blood pressure and underlying conditions
• Avoiding nephrotoxic medications
• Promoting healthy lifestyle habits including hydration and nutrition
• Genetic counseling for at-risk families