Natural History

The natural history of renal disease is variable and at times unpredictable. Although some patients may recover fully and suffer few or no sequelae (e.g., poststreptococcal glomerulonephritis, typical [diarrhea-positive] hemolytic-uremic syndrome), the majority of children and adolescents develop progressive renal disease and dysfunction, often leading to ESRD. The prevalence and severity of CKD complications increase as glomerular filtration rate decreases. Table 23-1 outlines these medical complications, which can be disruptive to the child's life. Furthermore, treatment interventions themselves may contribute to additional medical and emotional complications.

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