Journal of Kidney

Children with Chronic Kidney Disease: A Major Concern

Gaurav Singh Dangi^{* *}Correspondence: Gaurav Singh Dangi, Department of Biotechnology, Graphic Era Deemed University, Dehradun, India, Email:

Author info »

Introduction

Chronic Kidney Disease (CKD) is a serious public health issue across the world. Although it is uncommon in youngsters, it is a severe condition with several long-term repercussions. Childhood CKD has distinct traits and may be viewed, at least in part, as a separate nosologic entity. Furthermore, several common aspects of pediatric CKD, such as illness aetiology or cardiovascular problems, will have a long-term impact on the life of the adult that the child will become. This review will concentrate on the particular challenges of pediatric CKD, including aetiology, clinical characteristics, and management. Furthermore, we will cover CKD-related variables that begin in childhood and require adequate therapy to maximize health outcomes.

Chronic Kidney Disease (CKD) is a serious public health concern across the world, with a growing incidence and prevalence that threatens to spark an "epidemic". CKD is a clinical illness defined by a steady decline of kidney function over time, regardless of the underlying aetiology. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, for an instance, describe CKD as abnormalities of kidney structure or function that have been present for more than 3 months and have health consequences. The KDIGO criteria for classification and staging are not entirely relevant to the pediatric population. This definition was developed for the adult community, where CKD is a prevalent and well-known health condition.

Indeed, whereas pediatric CKD has the same underlying physio pathologic pathways as adult CKD, it may be regarded as a distinct nosologic entity in certain aspects. Childhood CKD exhibits clinical aspects that are unique to the paediatric age, including the disease's influence on growth. Furthermore, several of the common characteristics of paediatric CKD, such as aetiology or cardiovascular problems, indicate aspects that influence not only the patient's health throughout childhood but also the life of the adult that this kid will become. This influence is sometimes overlooked, but it should not be overlooked. Furthermore, CKD has a significant emotional impact on both the patient and his family. Parents must not only fulfil the duty of parents but also do various activities traditionally associated with nurses and physicians. As a result, we must be mindful that the improved clinical and therapeutic care of young patients with CKD may result in a significant number of impacted adults experiencing difficulties unique to CKD that began in childhood.

In this article, we will focus not only on the particular challenges associated with paediatric CKD, but also on those characteristics associated with CKD that begin throughout infancy and require adequate therapy to enhance patient health outcomes.

The primary causes of CKD in children differ greatly from those responsible for the disease's genesis in adults. CAKUT, Steroid-Resistant Nephrotic Syndrome (SRNS), chronic glomerulonephritis (e.g. lupus nephritis, Alport syndrome), and renal ciliopathies, in fact, account for approximately 49.1%, 10.4%, 8.1%, and 5.3% of cases, respectively, and for more than 70% of all paediatric CKD cases when considered together, as recently reported. Thrombotic microangiopathies (particularly atypical haemolytic uraemic syndrome), nephrolithiasis/nephrocalcinosis, Wilms tumour, viral and interstitial disorders, and others are less prevalent causes of CKD in children. 

The primary causes of CKD in children differ greatly from those responsible for the disease's genesis in adults. CAKUT, Steroid-Resistant Nephrotic Syndrome (SRNS), chronic glomerulonephritis (e.g. lupus nephritis, Alport syndrome), and renal ciliopathies, in fact, account for approximately 49.1%, 10.4%, 8.1%, and 5.3% of cases, respectively, and for more than 70% of all paediatric CKD cases when considered together, as recently reported. Thrombotic microangiopathies (particularly atypical haemolytic uraemic syndrome), nephrolithiasis/nephrocalcinosis, Wilms tumour, viral and interstitial disorders, and others are less prevalent causes of CKD in children.

CKD is a cunning illness. CKD, albeit uncommon in children, maybe a severe condition with several long-term effects. In reality, the death rate for children with ESRD receiving dialysis therapy is 30-150 times greater than in the general paediatric population, and a kid on dialysis has a 50-year lower life expectancy than a healthy child. Kidney transplantation improves prognosis significantly and is the best treatment choice for adolescents with ESRD. However, the majority of the problems of this clinical illness have an impact on the patient's health even before kidney function is irreparably lost, even if it is kept constant over time with conservative therapy.

In addition, despite similarities to the adult disease, CKD in children presents unique features and challenges that are not usually faced by adult patients and that make paediatric CKD a stand-alone nosologic entity. Nevertheless, paediatric nephrologists should be aware that complications in childhood CKD will have consequences well beyond paediatric age and influence outcomes of affected young adults with CKD. On the other hand, nephrologists who take care of young adults with CKD or adults with childhood CKD should understand the unique characteristics that CKD presents in children, especially the aetiology, in order to significantly ameliorate their patient's care.