Theme |
Pediatric end-stage kidney disease -- management of transition |
Title |
Medical management of congenital anomalies of the kidney and urinary tract |
Author |
Kiyohiko Hotta |
Department of Urology, Hokkaido University Hospital |
Author |
Kimihiko Moriya |
Department of Urology, Hokkaido University Hospital |
Author |
Ken Morita |
Department of Urology, Kushiro City General Hospital |
Author |
Daiki Iwami |
Department of Urology, Hokkaido University Hospital |
Author |
Nobuo Shinohara |
Department of Urology, Hokkaido University Hospital |
[ Summary ] |
Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of end-stage kidney disease (ESKD) in children. Patients with a kidney anomaly (renal dysplasia or hypoplasia) develop ESKD during early childhood because of a reduced nephron mass at birth. In contrast, renal function is maintained in most patients with urinary tract malformations until puberty. These patients frequently develop ESKD during adolescence because of recurring urinary tract infections. Therefore, long-term CKD and urinary management for patients with CAKUT are essential in delaying the progression of CKD to ESKD. Renal replacement therapy at an appropriate time is also important. An appropriate transition from pediatric to adult renal services is important to provide continuous and effective medical management from childhood to adulthood in patients with CKD. |