Chronic kidney disease

Chronic kidney disease is a condition that affects thousands of children all over the world, compromising their health and quality of life. Recent epidemiological studies have provided evidence suggesting that the number of patients is expected to grow. This growth can be attributed, on the one hand, to new emerging conditions predisposing to chronic kidney disease, such as low birth weight, prematurity, and obesity. On the other hand, huge progress has been made in the clinical management of children and infants with chronic kidney disease and end-stage renal disease, leading to a significant reduction in morbidity and mortality. As the natural evolution of chronic kidney disease is variable in children, a number of strategies (antihypertensive and anti-proteinuric therapies) aimed at slowing down its progression have been implemented. Current research is pointing in the direction of genetic and target therapies against the molecular-inflammatory process behind the loss of renal function. Growth failure and cardiovascular complications represent the greatest challenges for pediatric nephrologists. The gold standard therapy is preemptive transplantation and more advanced dialysis modalities are now widely available also for small children and infants.