Pediatric emergency medicine trisk 2911 2911

variety of complaints directly related to renal dysfunction including
hypertension, volume overload, anemia, and severe electrolyte or acid–base
abnormalities. They may also present with illness attributable to the
underlying disorder, such as urinary tract infections in those with complex
urologic disease and symptoms of systemic inflammation in those with
systemic vasculitis. Children with CKD have limited renal reserve and are
susceptible to AKI superimposed on chronic insufficiency, which will
increase the risk for metabolic derangements and volume excess.
TABLE 100.15
STAGES OF CHRONIC KIDNEY DISEASE
Stage Description

1
2
3a
3b
4
5

Kidney damage with normal or increased
glomerular filtration rate
Kidney damage with mildly decreased glomerular
filtration rate
Mildly to moderately decreased glomerular
filtration rate
Moderately to severely decreased glomerular
filtration rate
Severely decreased glomerular filtration rate
Kidney failure

Glomerular

filtration rate
(mL/min/1.73
m2)
≥90
60–89
45–59
30–44
15–29
<15 (or
dialysis)

Chronic kidney disease is defined as either kidney damage of glomerular filtration rate <60
mL/min/1.73 m2 or ≥3 mo. Kidney damage is defined as pathologic abnormalities or makers of
damage, including abnormalities in blood or urine tests or imaging studies.
Adapted from Hogg RJ, Furth S, LemLey KV, et al. National Kidney Foundation’s Kidney Disease
Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and
adolescents: evaluation, classification, and stratification. Pediatrics 2003;111:1416–1421.