Glomerular filtration rate (GFR) measurement is a key tool for determining the degree of chronic kidney disease. The assessment of GFR is even more challenging in children than in adults with more variables in the equation than race and sex. Monitoring the progress of the kidney disease can therefore be difficult as in the initial stages of a decline in kidney function, there are no clinical signs. Due to children’s growth and development, changes in muscle mass and growth impair GFR estimation based solely on serum creatinine values. More invasive methods of GFR measurement are more reliable, but techniques using ionising agents, requiring large volume blood samples or timed voiding, have limited application in children. This paper reviews the methods of measuring and determining glomerular filtration rate and kidney function in children.

There is no evidence of the most effective nutritional screening tool for hospitalized children. The present study aimed to develop a quick, simple, and valid screening tool for identifying malnutrition risk of hospital admission with non-invasive indicators. A cross-sectional study was conducted. Children`s nutritional baseline using a questionnaire, subjective malnutritional risk, and Subjective Global Nutritional Assessment were assessed on admission. Concurrent validity was assessed using American Society for Parenteral and Enteral Nutrition (ASPEN)and Academy of Nutrition and Dietetics assessment and Subjective Global Nutritional Assessment tool. A new screening tool Simple Pediatric Nutritional risk Screening tool (SPENS) was developed, and sensitivity, specificity and reliability were evaluated. A total of 180 children aged from 1 month to 18 years were included (142 in the development phase and 38 in the validation phase). SPENS consist of four variables and shows almost perfect agreement with subjective malnutritional risk assessment (κ = 0.837) with high sensitivity and specificity (93.3% and 91.3% respectively). Compared with Subjective Global Nutritional Assessment and ASPEN and Academy of Nutrition and Dietetics assessment, SPENS had sensitivity 92.9% and 86.7%, a specificity of 87.5% and 87.0%, and an overall agreement of 0.78 and 0.728, respectively. Due to the fast, simple, easy, and practical to use, screening the SPENS can be performed by nurses, physicians, and dieticians.

(1) Background: Ultrasound elastography is a novel ultrasound technique for evaluating tissue elasticity. One of the key factors influencing the measurement in children is excess weight. This study aimed to evaluate the effect of body composition, namely, fat mass, on liver and kidney ultrasound elastography in paediatric patients. (2) Methods: 114 participants, in whom bioimpedance, along with liver and kidney ultrasound elastography, were performed, were included (37 patients with chronic kidney disease, 46 patients with hypertension, and 31 healthy subjects). (3) Results: Bioimpedance analysis showed a significant correlation between liver elastography parameters and the phase angle (p = 0.002), fat-free mass (p = 0.001), body cell mass (p = 0.001), total body water (p = 0.001), extracellular water (p = 0.006), and, to lesser extent, fat mass (p = 0.041). On the contrary, kidney elastography parameters strongly correlated only with fat mass (p < 0.001 for both kidneys). (4) Conclusions: Liver and kidney stiffness increased in overweight participants and showed significant correlation with fat mass, particularly in the case of kidney elastography.

The aim of our study was to evaluate associations between body composition parameters and several clinical parameters. A total of 206 children and adolescents (120 male, 86 female) were prospectively included. Body impedance measurement was performed in all participants. During the hospital work-up, several clinical parameters such as anthropometric measurements and laboratory and ultrasound findings were obtained and correlated to body composition parameters. There was a significant association between body composition parameters and anthropometric measurements, systolic blood pressure, insulin levels, serum creatinine, urate, liver function tests, triglycerides, cholesterols and apolipoproteins, homocysteine, vitamin D and proteins in 24-h urine. Body composition differed by gender, between participants with and without hepatic steatosis and between patients with and without left ventricular hypertrophy. Interestingly, body composition did not correlate with diastolic blood pressure, pulse wave velocity and intima media thickness. This study showed that several clinical parameters are associated with body composition in children. Obesity and body composition play an important role in the development of other cardiovascular risk factors and are not dependent on fat mass alone, and the latter might be used for cardiovascular risk determination.

(1) Background: The transition of children with chronic kidney disease to adult care has become a well-handled issue. However, other patients with normal or mildly decreased renal function also requiring further management and transition are neglected. (2) Methods: A questionnaire was sent to patients with kidney pathology, aged 17 years and older.(3) Results: The patients were mostly high-school (55%) or college students (39%), living with their parents (94%). One third did not know how their disease affected their choice of profession and reproductive health. Furthermore, 46% of the respondents did not know who would continue with their care, and 44% still had a primary pediatrician. (4) Conclusions: A review of the literature on the topic was performed and summarized here. Regular education is the key for successful transfer, not only in chronic kidney and transplant patients, but also in others in whom a decline in renal function can be expected in the future.