5–58.3 cases per million children. Data from a study conducted in Japan indicated that the prevalence of CKD at pre-dialysis stages 3–5 in patients aged 3 months to 15 years was 29.8 cases per million children, and 91.1 % of these patients had non-glomerular disease, and among them, 68.3 % had CAKUT. The yearly incidence and prevalence of end-stage renal disease (ESRD) in patients

aged less than 20 years was reported to be 4 cases per million and 22 cases per million, respectively. CAKUT and hereditary nephropathies (49.8 %) were the most common causes of ESRD, AZD1390 cost and glomerulonephritis accounted for 22 % of cases. These findings are similar to those from the North American Pediatric Renal Trials and Tideglusib research buy Collaborative Studies registry and the ItalKid Project from Europe, in which the proportion of patients with CAKUT (48–59 %) was the largest, while the proportion of glomerulonephritis patients (7–14 %) was not so high. Overall, the main causes of CKD in children at stage 2 or higher are CAKUT or other FHPI inherited conditions. The proportion of ESRD caused by glomerulonephritis was lower in North America and Europe than in a Japanese study conducted in 2008 (22 %). This may be due to the age distribution of the patients, with fewer young patients being treated for ESRD at that time. Bibliography

1. Ardissino G, et al. Pediatrics. 2003;111:e382–7. (Level 4)   2. Ishikura K, et al. Nephrol Dial Transplant. 2013 (Epub ahead of print). (Level 4)   3. Hattori S, et al. Pediatr Nephrol. 2002;17:456–61. (Level 4)   Kidney function in children

1. Normal range and variability of the glomerular filtration rate (GFR)   Inulin is the gold Acetophenone standard used for measuring GFR to evaluate kidney function. However, there are no data of inulin-based GFRs according to age and gender in Japanese children. Therefore, the normal range of GFR according to age and gender were adapted using data from foreign countries (Table 11). Table 11 Normal GFR in children and adolescents Age (gender) Mean GFR ± SD (mL/min/1.73 m2) 1 week (male and female) 40.6 ± 14.8 2–8 weeks (male and female) 65.8 ± 24.8 >8 weeks (male and female) 95.7 ± 21.7 2–12 years (male and female) 133.0 ± 27.0 13–21 years (male) 140.0 ± 30.0 13–21 years (female) 126.0 ± 22.0 2. Estimated GFR (eGFR)   In clinical practice, GFR is usually estimated from creatinine clearance or the serum creatinine concentration. However, the conventional method of measuring renal inulin clearance in children is not feasible in clinical practice because constant intravenous infusion is required. In addition, bladder catheterization is sometimes required to ensure adequate urine collection from children, particularly in infants and young children.