What is included in the long-term monitoring of children with chronic kidney disease (CKD)?

Updated: Jul 21, 2020
  • Author: Sanjeev Gulati, MD, MBBS, DNB(Peds), DM, DNB(Neph), FIPN(Australia), FICN, FRCPC(Canada); Chief Editor: Craig B Langman, MD  more...
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All children with chronic kidney disease (CKD) require regular follow-up on an outpatient basis in a dedicated chronic kidney disease clinic until initiation of long-term renal replacement therapy. This involves a multidisciplinary team approach that involves the nephrologist, primary care physician, renal dietitian, nurse, and social worker. They should work in close coordination with the primary pediatrician or family physician.

Monitor calcium, phosphate, parathyroid hormone (PTH), and vitamin D levels on an ongoing basis in all children with chronic kidney disease, even those with mild disease who often have evidence of abnormalities in bone metabolism. There is a high prevalence of vitamin D insufficiency and deficiency across all stages of pediatric chronic kidney disease, particularly in nonwhite and obese patients, which may contribute to growth deficits during the earliest stages of this disease. [21]

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