Diagnostic Criteria of Chronic Renal Failure in Children

Chronic Renal Failure poses a great damage and greatly affects the quality of life in children. By knowing the diagnostic criteria, you can have a better understanding of the disease.

Age range: 0-14 years old.

Creatinine clearance rate (CCr) ﹤50 ml / (min·1.73 m)

Course of disease is in line with the following conditions:

Those with confirmed acute nephritis history more than 1 year; those with hidden onset more than 1/2 years; or those patients with renal failure who are caused by chronic pathological changes or genetic renal diseases.

Patients with confirmed renal history over one year or hidden onset more than 6 months or course of diseases less than 6 months, but the renal pathological test and clinical test (blood, routine urine test, calcium and phosphorus metabolism and B ultrasonic for kidneys etc.) manifest the renal diseases has enter into a chronic phase, features are same as CRF.

Renal function condition: blood urea nitrogen (BUN)﹥8.57 mmol / L( increase with SCr parallelly); serum creatinine rate (SCr) ﹥176.8 pmoL/L.

Have sign or symptoms such as renal anemia, slow-growing, hypertension and uremia etc.
According to a complete data shows that gender ratio is 1.49/1; average age of onset is 8.2 years old; average course before diagnosis is 2.5 years. Main primary diseases are chronic nephritis and renal syndromes which account for 52.7%; congenital or hereditary diseases account for about 1/4, which mainly are renal dysplasia and renal cystic disease. Primary clinical features at time of diagnosis are anemia, gastrointestinal reaction, edema, hypertension and growth retardation etc.

Treatment

Relieve the uremia symptoms and protect remaining renal function.

Place emphasis on nutrition in children with CRF. Do our best to provide enough caloric supply for those children. Daily caloric supply should not less than normal same-age children. Low-protein diet (LPD) becomes the foundation among nutrition issues. Suggestion: LPD begins when GRF﹤60ml / (min·1.73 m2); ﹤1 years old, 1.8g / (kg·d); 1-2 years old, 1.0-1.5g / (kg·d); 2-16 years old, 1 g / (kg·d); serious cases 0.6-1.0 g / (kg·d).

Add essential amino-acid, ketonic acid, water soluble vitamin (VitB, VitC and folic acid) on the basis of LPD.

We suggest that protein intake should be restrained when GRF down to 50% or even less.
Patients with GFR﹤5ml/min·1.73 m, supply 0.6g/kg·d protein including high quality protein0.35 g/kg·d.

Patients with no dialysis and GFR﹤25ml/min·1.73 m, if they are lack of caloric, provide 0.75 g/kg·d protein to them.

Patients with GRF 5-25ml/min·1.73 m, add 0.3 g/kg·d essential amino-acid or ketoanaloge KA.
For patients with hemodialysis: provide 1.2 g/kg·d protein.