Chronic Kidney Disease Staging

Um, one of the families is asking if we can explain the CKD staging once again, and this is such an important thing in what we do, so absolutely. So the chronic kidney disease staging is a safety. Mechanism of doctors involved in the care of your children being able to stratify how involved is your child's kidney health. Uh, stage 0 is when you have no damage to the function of the kidney and there are no anatomical abnormalities. CKD stage 1 is if you have an anatomical abnormality. The question was, does hydronephrosis cause you to have a, uh, a designation of CKD1? It depends. If your function is normal. And if your hydronephrosis is grade 1 or 2, which is just the least amount of hydronephrosis, probably not. But if your child has, you know, stage 4, I'm sorry, grade 4 hydronephrosis where the kidneys actually being thinned out by the degree of hydronephrosis, then absolutely, that would be a CKD stage 1 with normal function. If your doctor was to do urological testing and see what the renal function actually is, that's actually a better way of knowing where the CKD staging, uh, your child's going to fall on. So CKD1, normal function, but maybe a structural abnormality. Maybe they were only born with one kidney or had reflux or severe hydronephrosis, and it goes down based on blood tests to tell us what the child's creatinine and more importantly, their glomerular filtration rate, which is how much blood is being filtered by the kidneys each minute, and it goes from 1 all the way down to stage 5, which is where your child is, or the individual, because it's not just for children. Uh, individual is imminently looking at requiring either dialysis or transplant. One important thing about CKD staging is it only applies to children beyond the age of 2, because during the 1st 2 years of life, your children's renal function is really revving up and, um, being more mature as more and more nephrons are being recruited, and the nephron is the functional unit of the kidney. By age 2, the complement of nephrons that your child's kidneys have is set. They will no longer develop new nephrons, but it's the existing nephrons at that point that we're going to live the rest of our life with. So that's why the CKD staging is hard to apply to children less than 2, but it really is reliably appliable and applicable to children from 2 for the rest of their life. And it's very important, can't be done just with imaging testing, has to be done with blood tests, and we would strongly require, uh, request that you ask your doctors and healthcare providers to do that blood test at least once a year. To know what your child's kidney function is.