Management of pediatric chronic kidney disease

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  • Kamei Koichi
    Division of Nephrology and Rheumatology, National Center for Child Health and Development

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  • 小児の慢性腎臓病の管理─コツとpitfall ─

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Abstract

<p>The major cause of childhood chronic kidney disease (CKD) is congenital abnormalities of the kidney and urinary tract (CAKUT). For the management of the hypertension, we have to be careful about the difference by age, the variability of blood pressure, white coat hypertension and the possibility of nonadherence of patients. It is important to understand characteristics and major side effects of drugs. If infants of CKD present with growth failure due to poor nutrition, we had better start tube feeding. Low-protein diet is not recommended, although for some patients it might be useful. In patients with hypertension, salt restriction is effective. However, it is not recommended for some patients with CAKUT or nephronophthisis. Obesity is a risk factor for progression of CKD. Gene analysis is useful for the avoidance of strong immunosuppressive treatment, early detection of extra-renal diseases, predictions of post-transplant recurrences, and diagnosis of other patients in the family. In the management of pediatric CKD, we should provide individualised care to each patient depending on the condition.</p>

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