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Renal Diseases in Children: The Present and a Challenge for...
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Renal Diseases in Children: The Present and a Challenge for the Future

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Nephrology & Urology".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 2125

Special Issue Editor

Dr. Anna Di Sessa

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Studies of Campania "Luigi Vanvitelli", 80138 Napoli, Italy
Interests: pediatric obesity; nutrition; and metabolism; pediatric gastroenterology; pediatric liver diseases; obesity-related comorbidities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is an honor to serve as the Guest Editor for this Special Issue of Children, entitled “Renal Diseases in Children: The Present and a Challenge for the Future”. Renal diseases in childhood encompass a very wide range of conditions that significantly impact morbidity and mortality later in life. In particular, chronic kidney disease (CKD) is a global public health concern, currently affecting up to 10–15% of the general population. It is a complex, progressive chronic condition that represents a major risk factor not only for end-stage kidney disease but also for cardiovascular disease and other comorbidities.

Given the pathogenic role of the kidney in several biological processes and its involvement in various diseases with growing prevalence worldwide (e.g., diabetes, obesity), there is a need for additional investigation in the field of pediatric renal diseases.

The goal of this Special Issue is to discuss any aspects of pediatric renal diseases that could increase our understanding of these conditions by sharing knowledge about incompletely understood and controversial areas in this field.

We invite investigators to contribute original research articles and review articles that contribute to our continuing efforts to improve our understanding of this challenging field. As the title implies, new developments, and unconventional or inspirational contributions are also highly encouraged.

We look forward to receiving your contributions.

Dr. Anna Di Sessa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • renal function
  • child
  • adolescent
  • kidney injury
  • treatment
  • management
  • innovations

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Published Papers (3 papers)

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Research

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15 pages, 1769 KiB  
Article
Switching to the CKD-EPI but Not Modified FAS eGFR Formula Underdetects CKD Among Adolescents and Young Adults in México
by Alethia Paulina Monserrat Guzmán Núñez, Guido Filler, Olivier C. Barbier, Elodia Rojas Lima, Pablo Mendez-Hernández, Manolo Ortega-Romero, Maria Esther Díaz González de Ferris and Mara Medeiros
Children 2025, 12(2), 239; https://doi.org/10.3390/children12020239 - 17 Feb 2025
Viewed by 586
Abstract
Background: Guidelines recommend switching the glomerular filtration rate (eGFR) estimation from the CKiD-U25 to the CKD-EPI formula at age 18. We investigated how this would affect chronic kidney disease (CKD) classification. Methods: Serum creatinine was enzymatically measured in 1061 samples from 914 community-based [...] Read more.
Background: Guidelines recommend switching the glomerular filtration rate (eGFR) estimation from the CKiD-U25 to the CKD-EPI formula at age 18. We investigated how this would affect chronic kidney disease (CKD) classification. Methods: Serum creatinine was enzymatically measured in 1061 samples from 914 community-based 10–23-year-olds from Tlaxcala, Mexico, a region where urinary biomarkers demonstrated early kidney damage associated with exposure to inorganic toxins in a pediatric population. We calculated their eGFR using CKiD-U25, modified Schwartz, the first and modified Pottel full-age spectrum (FAS), and CKD-EPI formulae. Correlation analysis characterized the CKD stage stratified by age and sex. Results: At baseline, the median age was 13 (IQR: 12, 15) years, and 55% were female. Median CKiD-U25 eGFR was 96.9 (IQR: 83.3, 113.3) mL/min/1.73 m2, significantly lower than the CKD-EPI eGFR, which was 140.8 (IQR: 129.9, 149.3) mL/min/1.73 m2 (p < 0.0001, Wilcoxon rank test). The mean bias was 36.99 ± 12.89 mL/min/1.73 m2. Pearson correlation was r = 0.8296 (95% confidence interval 0.0898–0.8474). There was a better correlation between the modified Schwartz (r = 0.9421 (0.9349, 0.9485)) and the Pottel FAS (r = 0.9299 (0.9212, 0.9376)) formulae. Agreement was deficient when the eGFR was >75 mL/min/1.73 m2 in younger age and female sex. Modified Schwartz identified 281 (26.4%) measurements as having CKD 2 and 3 (2+), U25 identified 401 (37.7%) measurements as having CKD 2+, FAS identified 267 (25.1%) and modified FAS identified 282 (30%) measurements as having CKD 2+, and CKD-EPI identified 51 (4.8%) measurements as having CKD 2+, respectively. Conclusions: In this population, there needed to be better agreement between the various eGFR formulae. CKD-EPI identifies substantially fewer at-risk participants as having CKD. Full article
(This article belongs to the Special Issue Renal Diseases in Children: The Present and a Challenge for the Future)
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11 pages, 1261 KiB  
Article
Nephrogenic Diabetes Insipidus Affecting Three Males in Two Generations—Case Report and Review of the Literature
by Ramona Stroescu, Adela Chiriţă-Emandi, Maria Puiu, Flavia Chisavu, Ruxandra Steflea, Gabriela Doroş and Mihai Gafencu
Children 2025, 12(2), 195; https://doi.org/10.3390/children12020195 - 6 Feb 2025
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Abstract
Background: Nephrogenic diabetes insipidus (NDI) is defined as the inability of the kidney to concentrate urine owing to the insensitivity of the distal nephron to the antidiuretic hormone, arginine vasopressin. NDI is a heterogeneous rare autosomal dominant or X-linked disease. Objective: We present [...] Read more.
Background: Nephrogenic diabetes insipidus (NDI) is defined as the inability of the kidney to concentrate urine owing to the insensitivity of the distal nephron to the antidiuretic hormone, arginine vasopressin. NDI is a heterogeneous rare autosomal dominant or X-linked disease. Objective: We present a family with nephrogenic diabetes affecting three males in two generations. Methods: We report two boys with NDI: a 4-month-old infant who was treated for fever, vomiting, and failure to thrive, and his 10-year-old uncle (the mother’s brother), who was admitted concurrently for consuming 11 L of fluid per day. According to family history, the mother’s sibling passed away at the age of two from severe hypernatremic dehydration. Results: The infant’s clinical and laboratory evaluation revealed a 7.8 mL/kg/h urine output, hypernatremic hyperchloremic alkalosis, extremely low urine density (1002), and elevated copeptin level. In contrast, the uncle’s clinical and laboratory evaluation revealed marked polyuria, low urine density, and elevated copeptin, all of which were suggestive of diabetes insipidus. After starting hydrochlorothiazide treatment (2 mg/kg/body), the infant’s urine production reduced (2.85 mL/kg/h); however, severe hypokalemia and alkalosis followed. Spironolactone, an aldosterone antagonist, were added, with good therapeutic response. Hydrochlorothiazide was administered to the uncle, and his daily fluid intake decreased to 3–4 L. Given the family history, Sanger sequencing for the AVPR2 variant was performed on the boys and the infant’s mother. Analysis showed hemizygous likely pathogenic variant c.335G>A p. (Cys112Tyr) in the 2 boys and heterozygous (carrier) status of the mother. Within the same family, we observed phenotypic heterogeneity: one child died at the age of two, another lived well into ten years without therapy, and a four month-old baby could have had a poor outcome without specific treatment. Conclusions: NDI is a rare and possibly fatal genetic disorder with heterogeneous manifestations. In families with a history of NDI, molecular genetic testing is crucial for family planning. Full article
(This article belongs to the Special Issue Renal Diseases in Children: The Present and a Challenge for the Future)
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Review

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17 pages, 528 KiB  
Review
Pediatric Chronic Kidney Disease: Mind the Gap Between Reality and Expectations
by Chien-Ning Hsu, Pei-Chen Lu, Wei-Ting Liao and You-Lin Tain
Children 2025, 12(5), 614; https://doi.org/10.3390/children12050614 - 8 May 2025
Viewed by 381
Abstract
Pediatric chronic kidney disease (CKD) is a growing concern that often originates early in life, yet significant challenges remain in translating clinical guidelines into real-world practice. World Kidney Day 2025 highlights the importance of early detection, but the three levels of preventive strategies [...] Read more.
Pediatric chronic kidney disease (CKD) is a growing concern that often originates early in life, yet significant challenges remain in translating clinical guidelines into real-world practice. World Kidney Day 2025 highlights the importance of early detection, but the three levels of preventive strategies commonly recommended for adults may not be directly applicable to children. Unlike adult CKD, primary prevention in pediatrics should focus on prenatal, neonatal, and early-life factors such as congenital anomalies of the kidney and urinary tract (CAKUT), preterm birth, maternal health, and environmental exposures. Secondary prevention, involving early detection through screening, is crucial, yet the effectiveness of mass urinary screening in children remains a subject of global debate. Several key challenges persist, including the accurate estimation of glomerular filtration rate (eGFR), consistent definition and diagnosis of pediatric hypertension, identification of reliable biomarkers, and targeted screening in specific pediatric populations. Although clear guidelines exist to manage CKD progression and enhance quality of life, a critical gap remains between what is known and what is practiced. Closing this gap requires robust evidence to inform best practices, improve health-related quality of life, and advance pediatric kidney replacement therapies. To protect and improve kidney health for every child worldwide, these challenges must be acknowledged, and sustainable, evidence-based solutions must be developed and implemented without further delay. Full article
(This article belongs to the Special Issue Renal Diseases in Children: The Present and a Challenge for the Future)
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