Pediatric to Adult Nephrology Transition in CKD.

Abstract

Chronic kidney disease (CKD) affects roughly 10% of the general population. 1,2 Some adults with CKD were diagnosed with their condition during childhood. Because early CKD is often asymptomatic, obtaining reliable estimates of the true incidence of pediatric CKD (onset prior to age 18) is difficult due to the lack of routine screening for disease in children. 2,3 With advancements in healthcare (e.g. antenatal imaging, genetic testing) and improved survival outcomes for premature infants and children with complex care needs, a growing number of children with CKD will eventually transfer their care to adult specialists. The purpose of this review is to provide a practical summary of the challenges in the transition and transfer of care process for patients with non-dialysis requiring CKD, highlight differences in pediatric and adult care practices based on our experiences, and identify best practices. We will review both practitioner- and patient-related challenges as well as the unique healthcare needs of children with CKD during the transfer of care. We will also provide an overview of the transition and transfer of care for common causes of CKD in children that are less common in adults, such as congenital abnormalities of the kidney and urinary tract (CAKUT).