Chronic kidney disease stages are appropriate at all ages

Chronic kidney disease (CKD) is associated with multiple detrimental consequences to the cardiovascular and musculoskeletal systems. The effects of CKD are even more significant when they begin in childhood as they affect growth and (neuro-) development as well. The division into stages of CKD serves as a guideline for the physician to better anticipate and treat early and later manifestations of CKD. For that matter, in adults, the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative has published clinical practice guidelines, which are based on estimated glomerular filtration rate (eGFR). There are no such explicit guidelines published for the pediatric CKD population, mostly (and thankfully) due to its small number. However, given the excellent guidelines published in the adult literature and ongoing clinical work done by dedicated pediatric nephrologists, similar guidelines for children could be extrapolated and determined. As a matter of fact, the pediatric nephrology community is anxiously anticipating the results of the ongoing Chronic Kidney Disease in Children study, which is the first multicenter, prospective, observational pediatric study of such kind. This article summarizes the adequacy of CKD stages at all ages based not only on opinions of experienced clinicians, but also on evidence provided by cross-sectional data analyses of the Chronic Kidney Disease in Children study.