CKiD U25 eGFR Calculator for Children and Young Adults
Revised Schwartz CKiD U25 equation for estimating GFR in children and young adults aged 1-25 years using serum creatinine, cystatin C, BUN, height, and sex. More accurate than the bedside Schwartz equation.
Score interpretation
eGFR >= 90 -- normal kidney function (with or without other kidney damage markers)
→ If no other markers of kidney disease: no CKD; if haematuria/proteinuria present with normal eGFR: CKD G1; monitor annually; BP control; avoid nephrotoxins; normal diet; reassure family if isolated finding.
eGFR 60-89 -- mildly decreased; CKD G2 if other kidney damage markers present
→ Paediatric nephrology review; urine ACR/PCR; renal USS; BP monitoring (target < 50th percentile for age/sex/height; < 75th percentile on treatment); avoid NSAIDs; growth monitoring; nutrition review; annual bloods: U+E, FBC, phosphate, calcium, bicarbonate, PTH.
eGFR 30-59 -- moderate CKD; increased risk of complications
→ Paediatric nephrology referral urgently; manage complications: anaemia (iron, erythropoietin-stimulating agents), CKD-MBD (phosphate restriction, activated Vitamin D3, calcium supplements), growth hormone if growth faltering, metabolic acidosis (bicarbonate supplements); ACE inhibitor/ARB for proteinuric CKD; dietary referral; school support; CKD education for family; RRT planning if progressive; transplant workup discussion.
eGFR 15-29 -- severe CKD; renal replacement therapy planning required
→ Urgent paediatric nephrology management; RRT planning: haemodialysis, peritoneal dialysis, or pre-emptive transplant discussion with family; living donor evaluation; access planning (AV fistula, PD catheter); multidisciplinary: dietetics, social work, psychology, transplant team; intensive complication management; school and developmental support; palliative care input if appropriate (some children with complex needs).
eGFR < 15 -- kidney failure; renal replacement therapy or conservative care
→ Immediate paediatric nephrology and RRT team review; initiate RRT if indicated (fluid overload, hyperkalaemia, uraemic symptoms, metabolic acidosis); dialysis access; transplant listing if eligible; conservative care discussion if RRT not appropriate; palliative care; family support; psychological support; education accommodation; ensure growth and nutrition optimised.
Interpretation bands for the CKiD eGFR. Apply clinical judgement and local guidance.
References
- Pierce CB et al. Change in serial estimated GFR in children and young adults. Clin J Am Soc Nephrol. 2017;12(6):912-920.
- KDIGO. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1-150.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Vancomycin (Paediatric) · Glycopeptide Antibiotic — MRSA / Severe Gram-Positive Infections in Children
- Iron Supplementation (Paediatric) · Iron Supplement — Iron Deficiency Anaemia in Children
Featured in these MRCEM clinical pathways
The CKiD eGFR is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.