Principles in the management of chronic kidney disease

Chronic kidney disease (CKD) is the term used to describe renal disease or impairment which has persisted for three months. This paper presents a brief overview of CKD, including classification, epidemiology, aetiology, clinical presentation, investigations and a discussion regarding the principles of management. The aims of management include: preservation of remaining renal function, avoiding further injury, correction of electrolyte disturbances, anaemia and fluid imbalance and also maintenance of good nutrition, bone health and growth. Some children will progress to end-stage disease and there is a brief discussion of renal replacement therapy. Prognosis depends largely on the cause of CKD. Where children should be followed-up is dictated primarily by their renal function and the likely clinical course.