Chronic Kidney Disease

What is chronic kidney disease?

Chronic kidney disease (CKD) refers to the kidney’s progressive inability to perform its functions, regardless of the cause. These functions include:

  • cleaning your child’s blood — removing waste, toxins and extra fluid and maintaining the right chemical balance
  • regulating vitamins and minerals that help your child’s bones grow and develop
  • releasing hormones and vitamins that regulate the level of red blood cells your child’s body produces, help control blood pressure and regulate the amount of certain nutrients, such as calcium and potassium

In the past, the phrase “kidney failure” has been used to mean end-stage renal disease (ESRD) — when dialysis or a kidney transplant is necessary because the kidneys have lost around 85 percent of their function. Now the phrase “kidney failure” is falling out of favor and being replaced with chronic kidney disease.

CKD can be used to refer to people in the earliest stages of the disease, people who have moderate degrees of the disease, and people who already have end stage renal disease. This disease is progressive and ends in ESRD. ESRD can be treated effectively by either dialysis or a kidney transplant.

What are the stages of CKD?

Your child’s stage of CKD is primarily determined by her glomerular filtration rate (GFR) — a measurement of how effectively their kidneys are filtering blood. According to the National Kidney Foundation, there are five stages of chronic kidney disease:

  • Stage 1: Kidney damage with normal or increased GFR (≥90)
  • Stage 2: Kidney damage with mild decreased GFR (60-89)
  • Stage 3: Moderate decreased GFR (30-59)
  • Stage 4: Severe increased GFR (15-29)
  • Stage 5: Kidney failure (<15)

Keep in mind that this chart is a guide, and every child may experience symptoms differently. Since chronic kidney disease is progressive, many who have it will eventually reach Stage 5, but there are things we can do to slow the progression and minimize complications.

How common is CKD?

CKD is common in the United States. In fact there are more people with CKD (around 29 million) than there are with diabetes. In children, however, it’s very rare.

What risks are associated with CKD?

Complications may develop such as:

  • high blood pressure
  • anemia (low levels of red blood cells)
  • weak bones
  • malnutrition
  • growth failure
  • nerve damage

Since these complications are largely treatable, it’s important that kidney disease be diagnosed as early as possible.

How we care for chronic kidney disease

Our Division of Nephrology is the largest pediatric nephrology service in the United States. We care for patients with a wide range of kidney disorders, and we are home to the largest Kidney Transplant Program in New England dedicated to caring for children.

Our 7-bed dialysis unit is the only full-service pediatric dialysis unit in New England. If your child requires dialysis, our dialysis nurses, dietcians, tutors and child life specialists will do everything they can to make sure your child is comfortable during her treatments. Read more about dialysis.

Our compassionate caregivers know that your child is a person, not just a patient, and depending on your particular situation, we provide support services for your child and your family throughout all stages of treatment and recovery.