Kids And Kidneys Flashcards
Normal BP in children?
.
Causes of childhood hypertension?
White coat HT
Organic: renal, cardiac, endocrine
Lifestyle, familial (more and more these days)
End organ damage of HTN
Eyes
LVH
Kidneys(proteinuria)
Malignant HT? Symptoms? How to treat?
Headaches Blurry vision Nausea-vomiting Symptoms of raised ICP Slow-reduction of BP
Podocyte dysfunction get?
Proteinuria
Endothelial or BM dysfunction you get?
Haematuria
Haematuria: 3 things to consider for DDx
Pain
BP
Any proteinuria?
Always do what after urine dipstick?
Do a formal microscopy
Medical renal disease causes?
Hypercalciuria (crystals irritating) Thin BM disease Alport syndrome: X-linked GN -IgA, HSP Coagulopathy
Urological causes of haematuria?
Calculus
Tumour
Stricture
Trauma
How to assess proteinuria
24 hr collection
Spot collection
Glom HT causes?
Hyper filtration
Compensate for podocyte loss
Increased podocyte loss
Podocyte regenerates?
Nope
If find protein in urine, then do what?
Protein creatinine ratio
Minimal change disease cause?
Triggered by infection
Atopic
What age Minimal change disease?
Age 2-10
How to treat Minimal change disease?
Steroids: 2 weeks of high dose
Types of Glomerulonephritis?
FSGS, MPGN, SLE
Danger of Minimal change disease?
Relapses
Nephrotic syndrome def’n?
Acute inflammation, impaired filtration
Nephrotic syndrome you see what?
Haematuria - macroscopic
Proteinuria
Renal impairement, raised creatinine
Oliguria
What to use to visualize cells in urine in nephritic syndrome?
Phase contrast microscopy
Paediatric nephrotic syndrome, common cause?
Post-strep GN 2-4 weeks after
But any GN like SLE, IgA can cause it
Most important levels for post-strep GN?
Low complement levels: C3, C4
Rx for post-strep GN?
Furesemide
Causes of HUS?
Ecoli - shiva toxin
Uncooked meat
Outbreaks
HUS classic presentation?
Thrombotic microangiopathy Physical destruction from micro thrombi Not immune mediated Anaemia Thrombocytopaenia
What do you need to diagnose HUS?
Blood film
RBC fragments
HSP presentation?
Not really febrile Small vessels vasculitis GI Skin Joints
Long term risk of HSP?
Renal: nephritis - looks like IgA
Management of HSP?
acute - Steroids
Doesn’t prevent kidney involvement
HSP don’t forget?
Follow up, can take up to 6/12 for renal involvement in HSP to show up.
Angiotensin II will constrict what in lower levels?
likes to constrict Efferent arterioles
What common drug kids reduces prostaglandins production?
Ibuprofen
AKI - renal retention - water:
Oedema
AKI - renal retention -Na:
HTN
AKI - renal retention -K+:
Arrythmias
AKI - renal retention -acid:
Hyperventilation
AKI - renal retention -urea:
Nausea or vomiting
AKI - renal retention -phosphate:
Tetany, decrease Calcium
CKD in kids complications?
Anaemia
Bone disease
Impaired growth
Polyuria/polydipsia
Kidney transplantation worse outcomes in what age groups?
Adolescents: difficulty with adherence
