This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (81) Citing Articles via Google Scholar Google Scholar Articles by Hogg, R. J. Articles by Levey, A. S. Search for Related Content PubMed PubMed Citation Articles by Hogg, R. J. Articles by Levey, A. S. Related Collections Genitourinary Tract Social Bookmarking                         What's this?

PEDIATRICS Vol. 111 No. 6 June 2003, pp. 1416-1421

National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Chronic Kidney Disease in Children and Adolescents: Evaluation, Classification, and Stratification

Ronald J. Hogg, MD^*, Susan Furth, MD, PhD^,, Kevin V. Lemley, MD, PhD^¶, Ronald Portman, MD^||, George J. Schwartz, MD^**, Josef Coresh, MD, PhD^,, Ethan Balk, MD, MPH, Joseph Lau, MD, Adeera Levin, MD^¶¶, Annamaria T. Kausz, MD, Garabed Eknoyan, MD^|||| and Andrew S. Levey, MD

^* North Texas Hospital for Children and the Department of Clinical Research at Medical City Dallas Hospital, Dallas, Texas
Johns Hopkins University, Baltimore, Maryland
Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University School of Medicine, Baltimore, Maryland
^¶ Stanford University School of Medicine, Stanford, California
^|| University of Texas Houston Medical School, Houston, Texas
^** University of Rochester Medical Center, Rochester, New York
Bloomberg School of Public Health, Baltimore, Maryland
New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts
^¶¶ St Paul’s Hospital, University of British Columbia, Vancouver, Canada
^|||| Baylor College of Medicine, Houston, Texas

Objectives. A series of new guidelines has been developed by the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative to improve the detection and management of chronic kidney disease (CKD). In most instances of CKD, the earliest manifestations of the disorder may be identified by relatively simple tests. Unfortunately, CKD is often "underdiagnosed," in part because of the absence of a common definition of CKD and a classification of the stages in its progression. The Kidney Disease Outcomes Quality Initiative clinical practice guidelines for CKD evaluation, classification, and stratification provide a basis to remedy these deficits. The specific goals of the guidelines described in this review are to provide: 1) an overview of the clinical practice guidelines as they pertain to children and adolescents, 2) a simple classification of the stages of CKD, and 3) a practical approach to the laboratory assessment of kidney disease in children and adolescents.

Methods. The guidelines were developed as part of an evidence-based evaluation of CKD and its consequences in patients of all ages. The data that were used to generate the guidelines in this article were extracted from a structured analysis of articles that reported on children with CKD.

Results and Conclusions. This review presents the definition and 5-stage classification system of CKD developed by the work group assigned to develop the guidelines, and summarizes the major recommendations regarding the early detection of CKD. Major emphasis is placed on the identification of children and adolescents with CKD by measuring the protein-to-creatinine ratio in spot urine specimens and by estimating the glomerular filtration rate from serum creatinine using prediction equations.

Key Words: guidelines • chronic • kidney • children • classification

Abbreviations: CKD, chronic kidney disease • K/DOQI, Kidney Disease Outcomes Quality Initiative • NKF, National Kidney Foundation • GFR, glomerular filtration rate

---

Received for publication Oct 21, 2002; Accepted Jan 6, 2003.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G. J. Schwartz and D. F. Work Measurement and Estimation of GFR in Children and Adolescents Clin. J. Am. Soc. Nephrol., November 1, 2009; 4(11): 1832 - 1843. [Abstract] [Full Text] [PDF]

				R. Sinha, I. D. Davis, and M. Matsuda-Abedini Sleep Disturbances in Children and Adolescents With Non-Dialysis-Dependent Chronic Kidney Disease Arch Pediatr Adolesc Med, September 1, 2009; 163(9): 850 - 855. [Abstract] [Full Text] [PDF]

				D. S. Gipson, S. F. Massengill, L. Yao, S. Nagaraj, W. E. Smoyer, J. D. Mahan, D. Wigfall, P. Miles, L. Powell, J.-J. Lin, et al. Management of Childhood Onset Nephrotic Syndrome Pediatrics, August 1, 2009; 124(2): 747 - 757. [Abstract] [Full Text] [PDF]

				S. Menon, R. P. Valentini, G. Kapur, S. Layfield, and T. K. Mattoo Effectiveness of a Multidisciplinary Clinic in Managing Children with Chronic Kidney Disease Clin. J. Am. Soc. Nephrol., July 1, 2009; 4(7): 1170 - 1175. [Abstract] [Full Text] [PDF]

				R. J. Hogg Screening for CKD in Children: A Global Controversy Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 509 - 515. [Abstract] [Full Text] [PDF]

				C. M. P. Buysse, H. Raat, J. A. Hazelzet, J. M. Hulst, K. Cransberg, W. C. J. Hop, L. C. A. C. Vermunt, E. M. W. J. Utens, M. Maliepaard, and K. F. M. Joosten Long-term Health Status in Childhood Survivors of Meningococcal Septic Shock Arch Pediatr Adolesc Med, November 1, 2008; 162(11): 1036 - 1041. [Abstract] [Full Text] [PDF]

				D. Groesbeck, A. Kottgen, R. Parekh, E. Selvin, G. J. Schwartz, J. Coresh, and S. Furth Age, Gender, and Race Effects on Cystatin C Levels in US Adolescents Clin. J. Am. Soc. Nephrol., November 1, 2008; 3(6): 1777 - 1785. [Abstract] [Full Text] [PDF]

				S. Nguyen, C. McCulloch, P. Brakeman, A. Portale, and C.-y. Hsu Being Overweight Modifies the Association Between Cardiovascular Risk Factors and Microalbuminuria in Adolescents Pediatrics, January 1, 2008; 121(1): 37 - 45. [Abstract] [Full Text] [PDF]

				A. Mattman, S. Eintracht, T. Mock, G. Schick, D. W. Seccombe, R. M. Hurley, and C. T. White Estimating Pediatric Glomerular Filtration Rates in the Era of Chronic Kidney Disease Staging J. Am. Soc. Nephrol., February 1, 2006; 17(2): 487 - 496. [Abstract] [Full Text] [PDF]

				R. Hazra, R. I. Gafni, F. Maldarelli, F. M. Balis, A. N. Tullio, E. DeCarlo, C. J. Worrell, S. M. Steinberg, J. Flaherty, K. Yale, et al. Tenofovir Disoproxil Fumarate and an Optimized Background Regimen of Antiretroviral Agents as Salvage Therapy for Pediatric HIV Infection Pediatrics, December 1, 2005; 116(6): e846 - e854. [Abstract] [Full Text] [PDF]

				J. Chandar, O. Gomez-Marin, R. del Pozo, L. Sanders, B. Montane, C. Abitbol, J. Strauss, and G. Zilleruelo Role of Routine Urinalysis in Asymptomatic Pediatric Patients Clinical Pediatrics, January 1, 2005; 44(1): 43 - 48. [Abstract] [PDF]

				S. M. Hewitt, J. Dear, and R. A. Star Discovery of Protein Biomarkers for Renal Diseases J. Am. Soc. Nephrol., July 1, 2004; 15(7): 1677 - 1689. [Abstract] [Full Text] [PDF]