Chronic kidney disease in children: definition, classification and diagnostics

Chronic kidney disease (CKD) occupies a special place among chronic non-infection diseases because it is associated with a deterioration in the quality of life, high mortality and in the terminal stage with the need to use expensive methods of replacement therapy - dialysis and kidney transplantation. The principle of determining CKD was developed for the adult population and, despite the presence of clear recommendations for definition, classification, diagnosis and treatment, there are many unresolved issues for all stages of CKD diagnosis in pediatric patients. The article describes age-related changes in glomerular filtration rate (GFR) in children. The advantages and disadvantages of endogenous and exogenous markers of GFR are detailed. Particular attention is paid to modern methods of measuring of the creatinine and cystatin C concentrations in blood and their standardization. The criteria for definition and classification of CKD, the features of its use in children under 2 years of age are described in detail. The characteristics of the CKD causes in pediatric practice are given. Validated formulas for calculating GFR for pediatric patients with CKD are presented: “bedside” Schwartz equation (2009), Schwartz-Lyon equation (2012), creatinine and creatinine-cystatin C based CKiD equations, as well as screening equations for calculating the GFR for a healthy child population: simple, age-dependent and growth-dependent Q equations, FM (Flanders Metadata) equation, taking into account possible age ranges of their use, advantages and limitations. The sequence of using formulas for a more accurate determination of GFR and the stage of CKD in children is given. The article also describes age-related changes in albuminuria, stages of pathological albuminuria, the assessment of which contributes to predicting the progression and outcome of CKD, serves as a guide to the adequacy of renoprotective therapy. The presented data are aimed to make CKD diagnosis in children on time and accurate grading of CKD and albuminuria stages.

хроническая болезнь почек, дети, классификация, диагностика, формулы расчета скорости клубочковой фильтрации, chronic kidney disease, children, classification, diagnostics, equations for calculating glomerular filtration rate

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