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Kidney disease in children: latest advances and remaining challenges

Abstract

To mark World Kidney Day 2016, Nature Reviews Nephrology invited six leading researchers to highlight the key advances and challenges within their specialist field of paediatric nephrology. Here, advances and remaining challenges in the fields of prenatal patterning, acute kidney injury, renal transplantation, genetics, cardiovascular health, and growth and nutrition, are all discussed within the context of paediatric and neonatal patients with kidney disease. Our global panel of researchers describe areas in which further studies and clinical advances are needed, and suggest ways in which research in these areas should progress to optimize renal care and long-term outcomes for affected patients.

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Figure 1: Morphologic stages of metanephric kidney development.
Figure 2: Milestones in paediatric acute kidney injury (AKI) research.
Figure 3: Renal allograft failure rate according to age in patients first transplanted <40 years of age.
Figure 4: Bone disease and arterial calcification due to dysregulated mineral homeostasis in children with advanced chronic kidney disease (CKD).
Figure 5: Height and weight Z scores at the time of kidney transplantation for recipients included in the NAPRTCS registry between 1987 and 2013.

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Acknowledgements

The authors would like to thank their colleagues in the field and the efforts of the World Kidney Day initiative, for which the focus for 2016 is “Kidney Disease & Children. Act Early to Prevent It”. J.F.B. is supported by grants from the National Health and Medical Research Council (NHMRC) of Australia, the Diabetes Australia Research Trust (DART), and Monash University. S.L.G. has received funding from the agency for Healthcare Research (grant numbers AHRQ CERT 1U19HS021114 and AHRQ 1R18HS023763-01), the Casey Lee Ball Foundation, and the National Institute for Diabetes, Digestive and Kidney Diseases (grant number NIH P50 DK096418). L.P. has received support for this work from the KfH Foundation for Preventive Medicine. F.S. has received support for this work from the EU 7th Framework Programme (grant number 2012–305608), the KfH Foundation for Preventive Medicine, and the Research Programme of the European Renal Association–European Dialysis and Transplant Association. R.C.S. was supported by the National Institute for Health Research Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London. B.A.W. receives support from the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Heart, Lung and Blood Institute (grants UO1-DK-66143, UO1-DK-66174, UO1-DK-82194, and UO1-DK-66116).

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Correspondence to John F. Bertram or Stuart L. Goldstein or Lars Pape or Franz Schaefer or Rukshana C. Shroff or Bradley A. Warady.

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S.L.G. has received research grants and consultancy fees, and is a member of the expert panel and speaker's bureau for Baxter and Gambro Renal Products, is a consultant for Akebia, Bellco, and AM Pharma, and is a member of the steering committee for trials for both Otsuka and La Pharmaceuticals. L.P. has received travel support and speaker honoraria from Alexion, Novartis, and Raptor as well as research grants from Novartis. F.S. has received consultancy fees and speaker honoraria from Alexion. R.C.S. has received speaker honoraria from Fresenius Medical Care and Amgen. B.A.W. has received speaker honoraria from Alexion and consultancy fees from Amgen. J.F.B. declares no competing interests.

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4C

AWAKEN

AWARE

CKiD

GUDMAP

IPDN

NAPRTCS

TRANSNephro

World Kidney Day

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Bertram, J., Goldstein, S., Pape, L. et al. Kidney disease in children: latest advances and remaining challenges. Nat Rev Nephrol 12, 182–191 (2016). https://doi.org/10.1038/nrneph.2015.219

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