tailieunhanh - CHRONIC KIDNEY DISEASE

Background: Chronic kidney disease (CKD) is characterized by an irreversible deterioration of renal function that gradually progresses to end-stage renal disease (ESRD). CKD has emerged as a serious public health problem. | CHRONIC KIDNEY DISEASE Background Chronic kidney disease CKD is characterized by an irreversible deterioration of renal function that gradually progresses to end-stage renal disease ESRD . CKD has emerged as a serious public health problem. Data from the United States Renal Data System USRDS show that incidence of kidney failure is rising among adults and is commonly associated with poor outcomes and high cost. In the past decade the incidence of the CKD in children has steadily increased with poor and ethnic minority children disproportionately affected. The major health consequences of CKD include not only progression to kidney failure but also an increased risk of cardiovascular disease. Evidence-based clinical practice guidelines support early recognition and treatment of CKD-related complications to improve growth and development and ultimately quality of life in children with this chronic condition. Appropriate pediatric care may reduce the prevalence of this complex and expensive condition. The definition and classification of chronic renal disease may help identify affected patients possibly resulting in the early institution of effective therapy. To achieve this goal the Kidney Disease Outcomes Quality Initiative K DOQI working group of the National Kidney Foundation of the United States defined CKD as evidence of structural or functional kidney abnormalities abnormal urinalysis imaging studies or histology that persist for at least three months with or without a decreased glomerular filtration rate GFR as defined by a GFR of less than 60 mL min per m2 . Causes The chief causes of CKD in children include the following Obstructive uropathy Hypoplastic or dysplastic kidneys Reflux nephropathy Focal segmental glomerulosclerosis as a variant of childhood nephritic syndrome Polycystic kidney disease both autosomal-recessive and autosomal-dominant varieties Lab Studies Initial testing must include an examination of the urine and estimation of the GFR. An .