Nephrology Flashcards
Most common glomerular disease in children
IgA nephropathy
Presents within 1-2 days of URTI with gross hematuria
IgA nephropathy
Labs in IgA nephropathy
Normal C3/C4
What increased risk of poor prognosis in IgA nephropathy
persistent HTN, diffuse mesangial proliferation, extensive glomerular crescents and glomerular sclerosis
Most common vasculitis of childhood
HSP
leukocytoclastic vasculitis
HSP
Who is at increased risk for HSP
eriodic fever syndromes, complement deficiencies
Diagnosis of HSp
Palpable prurpuric rash and one of abdo pain, arthritis, biopsy with IgA deposition, renal involvement
What % with HSP progress to ESRD
1-2%
Labs in HSp
can be normal, can have increased WBC, increased plt, mild anemia, increased ESR and CRP
How to treat HSP
Supportive
steroids can be used for severe GI involvement but doesn’t alter prognosis for nephritis
IVIG if severe
What is recurrence risk in HSP
15-60%, usually wihtin 4-6 mo
Monitoring in HSp
should have weekly ua during active disease nad then monthyl for 6mo
Causes of renal vein thrombosis in bbs
asphyxia, dehydration, shck, sepsis, hypercoagulability, central venous catheters, maternal DM or preeclampsia
Causes RVT in kids
nephrotic syndroe, cyanotic heart disease, coaguloapthies, post kidnt transplant, contrast
How does RVT present
sudden onset gross hematuria and unilateral or bilateral flank masses
Treatment for RVT
bilateral then treat with tpa and unfractionated heparain
unilateral no consensus on whether to treat or not
predominant renal lesion in TS
renal angiomyolipoma
Hypercalciuria, hypokalemia, osteoenia and FTT
Distal (Type 1) RTA
Causes of proximal RTA
cytinosis, tyrosinemia, galactosemia, hereditary fructos intolerance, Wilson disease, Lowe syndrome, mitochondrial disease), medications (aminoglycosides, alkylating agents), toxins
Rapid correction of hypoNa= risk for
central pontine myelnolysis
Rapid correction of rhyperntremia = risk of
cerebral edema
Symptoms of hypernatremia
lethargy, irritability, nuchal rigidity, seizures,c oma
intracranial hemorrhage may occur due to rapid shift of water from brain cells with associated cerebral cessel distension
Calculation for free water deficity
weight x TBW (0.7 in infant, 0.65 n child) x measured Na=145/145
How much to correct sodium
6-8 in 24 h, notmore than 12
What % of cardiac output goes to your kidney
25%