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variety of complaints directly related to renal dysfunction including hypertension, volume overload, anemia, and severe electrolyte or acid–base abnormalities They may also present with illness attributable to the underlying disorder, such as urinary tract infections in those with complex urologic disease and symptoms of systemic inflammation in those with systemic vasculitis Children with CKD have limited renal reserve and are susceptible to AKI superimposed on chronic insufficiency, which will increase the risk for metabolic derangements and volume excess TABLE 100.15 STAGES OF CHRONIC KIDNEY DISEASE Stage Description 3a 3b Kidney damage with normal or increased glomerular filtration rate Kidney damage with mildly decreased glomerular filtration rate Mildly to moderately decreased glomerular filtration rate Moderately to severely decreased glomerular filtration rate Severely decreased glomerular filtration rate Kidney failure Glomerular filtration rate (mL/min/1.73 m2) ≥90 60–89 45–59 30–44 15–29