# Pediatric Chronic Kidney Disease During Pandemic Conditions—A Single-Center Experience

## TL;DR

This study compares the diagnosis and progression of chronic kidney disease in children before and during the pandemic, finding delays in diagnosis and more advanced cases during pandemic conditions.

## Contribution

The study is the first to analyze newly diagnosed pediatric CKD cases during the pandemic, revealing delayed diagnosis and more advanced disease stages.

## Key findings

- Children diagnosed with CKD during the pandemic presented with more advanced stages of the disease.
- There was an increased trend in glomerulopathies and acute kidney injury during pandemic conditions.
- Disrupted healthcare access likely contributed to delayed CKD diagnosis in children.

## Abstract

Background/Objectives: The prevalence of chronic kidney disease (CKD) is increasing worldwide, and this tendency is also visible in pediatric patients. The major clinical challenge is to achieve a diagnosis as early as possible, despite an overt clinical course, especially in the early stages of the disease. Unfavorable external conditions may disturb the proper treatment of chronically ill patients and delay the time of diagnosis. The recent COVID-19 pandemia might have altered the usual diagnostic pathways of different comorbidities, and CKD was probably one of them. However, there are no data on newly diagnosed CKD in children during the time of the pandemia, so our aim was to approach this problem. Methods: We analyzed medical records of 154 children with CKD who were hospitalized in the Department of Pediatric Nephrology in prepandemic (years 2015–2019) vs. pandemic and postpandemic (2020–2024) conditions, analyzing the eGFR value and stage of CKD at diagnosis, the underlying diseases leading to CKD, and sex-related differences. Results: The number of patients who were diagnosed with CKD in both time periods was comparable. Children hospitalized in the years 2020–2024 presented more often with advanced stages of CKD. The trend towards an increasing share of glomerulopathies, acute kidney injury, and unknown causes of CKD was noticeable under pandemic conditions. Conclusions: The COVID-19 pandemic could, probably owing to reduced access to primary healthcare and disrupted routine check-ups, delay the process of diagnosing CKD in children.