Paediatric Clinical Chemistry, Renal Physiology

Question 1

Common problems with low birth weight

Answer 1

• Respiratory distress syndrome
• Retinopathy of prematurity
• Intraventricular haemorrhage
• Patent ductus arteriosus
• Necrotizing enterocolitis - inflammation of bowel wall - necrosis and perforation

Question 2

Paediatric Renal Function

Answer 2

• Functional maturity of glomerular filtration rate only by 2 years of age
• Less reabsorption than adult due to short proximal tubule
• Reduced concentrating ability due to short loops of Henle and distal collecting ducts
• Persistant sodium loss due to distal tubule being relatively aldosterone insensitive

Question 3

Normal glomerular filtration rate

Answer 3

(GFR) = 120ml/hr

Age related decline of approx 1ml/hr/yr

Question 4

Gold standard measure of GFR?

Answer 4

Inulin

- requires steady state infusion and difficult to assay so it is reserved for research purposes only

Question 5

AKI - Pre-renal

Answer 5

Reduced renal perfusion with no structural abnormality

Question 6

AKI - Renal

Answer 6

Vascular, glomerular, tubular or intestinal

Question 7

AKI - Post-renal

Answer 7

Characterised by obstruction to urinary flow

Question 8

Chronic Kidney Disease - Stage 1

• description
• GFR
• Prevalence (% of pop)

Answer 8

• Kidney Damage with normal GFR
• GFR>90ml/min
• 3.3%

Question 9

Chronic Kidney Disease - Stage 2

• description
• GFR
• Prevalence (% of pop)

Answer 9

• Mild decreased GFR
• 60-89
• 3%

Question 10

Chronic Kidney Disease - Stage 3

• description
• GFR
• Prevalence (% of pop)

Answer 10

• Moderately decreased GFR
• 30-59
• 4.3%

Question 11

Chronic Kidney Disease - Stage 4

• description
• GFR
• Prevalence (% of pop)

Answer 11

• Severely decreased GFR
• 15-29
• 0.2%

Question 12

Chronic Kidney Disease - Stage 5

• description
• GFR
• Prevalence (% of pop)

Answer 12

-End stage kidney failure

-

Question 13

Commonest causes of Chronic Kidney Disease?

Answer 13

-Diabetes
-Atherosclerotic renal disease
-Hypertension
-Chronic Glomerulonephritis
-Infective or obstructive uropathy
Polycystic kidney disease

Question 14

Consequences of Chronic Kidney Disease?

Answer 14

1) Progressive failure or homeostatic function
- Acidosis
- Hyperkalaemia
2) Progressive Failure of hormonal function
- Anaemia
- Renal Bone Disease
3) Cardiovascular disease
- Vascular calcification
- Uraemic cardiomyopathy
4) Uraemia and Death