Introduction 1 2 1 3 4 5 2 5 6 7 6 Classification of CKD 1 8 9 2 2 10 Table 1 8 Stage Description 2 1 Kidney damage with normal or increased GFR >90 2 Kidney damage with mild decrease in GFR 60–89 3 Moderate decrease in GFR 30–59 4 Severe decrease in GFR 15–29 5 Kidney failure <15 or dialysis GFR Table 2 8 Age 2 1 week (males and females) 41 ± 15 2–8 weeks (males and females) 66 ± 25 >8 weeks (males and females) 96 ± 22 2–12 years (males and females) 133 ± 27 13–21 years (males) 140 ± 30 13–21 years (females) 126 ± 22 Sources of pediatric data 11 12 13 14 16 10 2 17 10 5 6 18 Cr 2 19 vide infra 20 21 22 23 Incidence and prevalence of CKD in childhood 1 4 Cr 2 19 Cr 2 16 15 Cr 2 12 5 22 27 Cr 2 26 Cr 2 27 n Cr 2 23 22 n Cr 2 25 5 5 5 20 21 28 5 vide supra 1 5 Fig. 1 left 5  29 30 10 16 19 22 23 25 27 19 31 32 Etiology of CKD Unlike adults in whom diabetes and hypertension are responsible for the majority of CKD, congenital causes are responsible for the greatest percentage of all cases of CKD seen in children. However, whereas this is the most common reported etiology from developed countries where CKD is diagnosed in its earlier stages, infectious or acquired causes predominate in developing countries, where patients are referred in the later stages of CKD. These generalizations apart, certain disorders giving rise to CKD are, indeed, more common in some countries than in others. 3 10 Table 3 10 Distributions by diagnosis Number Percent Male Percent white Percent black Percent other Total 6,405 64 61 19 20 Primary diagnosis  Obstructive uropathy 1,385 86 61 21 17  Aplastic/hypoplastic/dysplastic kidney 1,125 62 62 17 21  Other 913 58 63 16 21  FSGS 557 57 40 39 21  Reflux nephropathy 536 53 74 6 20  Polycystic disease 257 55 74 11 15  Prune belly 185 97 62 23 15  Renal infarct 155 53 66 13 21  Unknown 168 52 47 20 32  HUS 134 58 81 7 11  SLE nephritis 96 25 27 41 32  Cystinosis 97 48 92 3 5  Familial nephritis 99 86 61 12 27  Pyelo/interstitial nephritis 87 39 64 20 16  Medullary cystic disease 82 50 84 9 7  Chronic GN 76 50 43 29 28  MPGN-type I 67 61 48 19 33  Berger’s (IgA) nephritis 64 63 64 16 20  Congenital nephrotic syndrome 68 46 46 12 43  Idiopathic crescentic GN 46 48 52 24 24  Henoch-Schönlein nephritis 40 65 78 3 20  MPGN-type II 29 72 79 3 17  Membranous nephropathy 33 48 30 39 30  Other systemic immunologic disease 25 32 40 32 28  Wilms tumor 28 54 57 21 21  Wegener’s granulomatosis 17 76 94 0 6  Sickle cell nephropathy 13 62 0 92 8  Diabetic GN 11 50 36 45 18  Oxalosis 6 67 83 0 17  Drash syndrome 6 100 67 0 33 FSGS HUS SLE GN MPGN IgA 19 33 20 34 28 21 27 n 24 26 25 Progression of CKD 35 37 38 39 40 41 42 46 47 48 49 49 50 51 10 19 19 p 10 52 Outcome for children with CKD 29 22 23 30 5 21 2 5 Fig. 2 left 5  2 5 2 5 10 5 18 53 54 55 57 5 58 6 7 59 5 5 Conclusion 48