CKD is classified in 5 stages (adults):
Stage 1. Kidney damage with normal or elevated GFR (GFR >90 mL/min/1.73m^2 )
Stage 2. Kidney damage with mild decrease of GFR (GFR 60-89 mL/min/1.73m^2 )
Stage 3. Moderate decrease of GFR (GFR 30-59 mL/min/1.73m^2 )
Stage 4. Severe decrease of GFR (GFR 15-29 mL/min/1.73m^2 )
Stage 5. Kidney failure (<15 mL/min/1.73m^2 or dialysis)
As mentioned before, the Schwartz and Cockcroft-Gault formulas are used in
children to calculate the GFR.
End Stage Renal Disease (ESRD) refers to those patients with kidney failure that
require long term dialysis or transplantation.
Indications for RRT in children with CKD are based on the level of renal function,
uremic syndrome, availability of therapy and patient’s preference. [36]
Peritoneal dialysis
Peritoneal dialysis (PD) is a form of RRT that uses the peritoneum as a
membrane for interchange of solutes and water. PD is easy to apply to small
children and in those requiring chronic RRT. PD is performed on a daily basis at
home, therefore, family involvement and continuous commitment is important if
chosen as a preferred therapy.
The peritoneum provides a surface of approximately 40 m^2 in the adult. This
extensive absorptive surface allows for an effective exchange of water and
solutes and transfer of proteins and cells in normal circumstances. Its large
surface is mainly due to the existence of microvilli which, along with tight