Screening for CKD in children: a global controversy

Area of Science:

• Pediatric Nephrology
• Public Health Screening
• Renal Medicine

Background:

• Uncertainty exists regarding the effectiveness of early detection of renal disorders in children for preventing end-stage renal disease (ESRD).
• Concerns persist about the cost-effectiveness of implementing widespread urinary screening programs for pediatric chronic kidney disease (CKD).

Purpose of the Study:

• To review the relevance and current practices of urinary screening for CKD in children.
• To discuss the reporting standards for estimated glomerular filtration rates (eGFR) in pediatric clinical laboratories.

Main Methods:

• Review of current literature and guidelines on pediatric CKD screening.
• Analysis of trends in mass screening adoption across different geographical regions.
• Examination of recommendations from pediatric health organizations.

Main Results:

• Mass urinary screening for CKD is established in some Asian countries but is declining in North America and Europe.
• Leading pediatric organizations, such as the American Academy of Pediatrics, have moved away from recommending routine urinalysis in children.
• There is a need to address standardized reporting of estimated glomerular filtration rates (GFR) for pediatric patients.

Conclusions:

• The efficacy and cost-effectiveness of mass urinary screening for pediatric CKD remain subjects of ongoing debate.
• Shifting away from universal screening reflects evolving understanding and recommendations in pediatric nephrology.
• Standardized reporting of eGFR is crucial for accurate pediatric kidney function assessment.