Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations

Pediatric chronic kidney disease (CKD) is a growing concern that often originates early in life, yet significant challenges remain in translating clinical guidelines into real-world practice. World Kidney Day 2025 highlights the importance of early detection, but the three levels of preventive strat...

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Main Authors: Chien-Ning Hsu, Pei-Chen Lu, Wei-Ting Liao, You-Lin Tain
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/12/5/614
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author Chien-Ning Hsu
Pei-Chen Lu
Wei-Ting Liao
You-Lin Tain
author_facet Chien-Ning Hsu
Pei-Chen Lu
Wei-Ting Liao
You-Lin Tain
author_sort Chien-Ning Hsu
collection DOAJ
description Pediatric chronic kidney disease (CKD) is a growing concern that often originates early in life, yet significant challenges remain in translating clinical guidelines into real-world practice. World Kidney Day 2025 highlights the importance of early detection, but the three levels of preventive strategies commonly recommended for adults may not be directly applicable to children. Unlike adult CKD, primary prevention in pediatrics should focus on prenatal, neonatal, and early-life factors such as congenital anomalies of the kidney and urinary tract (CAKUT), preterm birth, maternal health, and environmental exposures. Secondary prevention, involving early detection through screening, is crucial, yet the effectiveness of mass urinary screening in children remains a subject of global debate. Several key challenges persist, including the accurate estimation of glomerular filtration rate (eGFR), consistent definition and diagnosis of pediatric hypertension, identification of reliable biomarkers, and targeted screening in specific pediatric populations. Although clear guidelines exist to manage CKD progression and enhance quality of life, a critical gap remains between what is known and what is practiced. Closing this gap requires robust evidence to inform best practices, improve health-related quality of life, and advance pediatric kidney replacement therapies. To protect and improve kidney health for every child worldwide, these challenges must be acknowledged, and sustainable, evidence-based solutions must be developed and implemented without further delay.
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spelling doaj-art-cb3a89a9357f4174b32d1a291346b2cd2025-08-20T03:47:49ZengMDPI AGChildren2227-90672025-05-0112561410.3390/children12050614Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and ExpectationsChien-Ning Hsu0Pei-Chen Lu1Wei-Ting Liao2You-Lin Tain3Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDivision of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDivision of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanDivision of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanPediatric chronic kidney disease (CKD) is a growing concern that often originates early in life, yet significant challenges remain in translating clinical guidelines into real-world practice. World Kidney Day 2025 highlights the importance of early detection, but the three levels of preventive strategies commonly recommended for adults may not be directly applicable to children. Unlike adult CKD, primary prevention in pediatrics should focus on prenatal, neonatal, and early-life factors such as congenital anomalies of the kidney and urinary tract (CAKUT), preterm birth, maternal health, and environmental exposures. Secondary prevention, involving early detection through screening, is crucial, yet the effectiveness of mass urinary screening in children remains a subject of global debate. Several key challenges persist, including the accurate estimation of glomerular filtration rate (eGFR), consistent definition and diagnosis of pediatric hypertension, identification of reliable biomarkers, and targeted screening in specific pediatric populations. Although clear guidelines exist to manage CKD progression and enhance quality of life, a critical gap remains between what is known and what is practiced. Closing this gap requires robust evidence to inform best practices, improve health-related quality of life, and advance pediatric kidney replacement therapies. To protect and improve kidney health for every child worldwide, these challenges must be acknowledged, and sustainable, evidence-based solutions must be developed and implemented without further delay.https://www.mdpi.com/2227-9067/12/5/614chronic kidney diseaseguidelinedevelopmental origin of health and disease (DOHaD)congenital anomalies of the kidney and urinary tract (CAKUT)childrenbiomarker
spellingShingle Chien-Ning Hsu
Pei-Chen Lu
Wei-Ting Liao
You-Lin Tain
Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
Children
chronic kidney disease
guideline
developmental origin of health and disease (DOHaD)
congenital anomalies of the kidney and urinary tract (CAKUT)
children
biomarker
title Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
title_full Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
title_fullStr Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
title_full_unstemmed Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
title_short Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
title_sort pediatric chronic kidney disease mind the gap between reality and expectations
topic chronic kidney disease
guideline
developmental origin of health and disease (DOHaD)
congenital anomalies of the kidney and urinary tract (CAKUT)
children
biomarker
url https://www.mdpi.com/2227-9067/12/5/614
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