Growing old before growing up

Frailty is a condition commonly associated with aging, characterized by functional and cognitive decline, increasing dependence, and early mortality, but it is rarely conceptualized in children. We present a caregivers' perspective on frailty in her daughter living with childhood chronic kidney disease, highlighting the repercussions of chronic kidney disease and treatment on physical and psychosocial functioning across critical developmental years. The cumulative consequences of the deficits ultimately impaired long-term life participation and quality of life. However, frailty is increasingly recognized as a dynamic condition with the potential to be slowed down, arrested, or, in some instances, even reversed. There is, therefore, a need to better understand frailty in children, define tools that are developmentally appropriate, and ultimately routinize the measure and management of frailty within pediatric chronic kidney disease care. Children with chronic kidney disease deserve the opportunity to grow, flourish, participate in life, and enter adulthood with the best possible quality of life.