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Child health > Paediatric renal failure > Flashcards

Paediatric renal failure Flashcards

1
Q

What are pre-renal causes of acute renal failure

A

Hypovolaemia - fluid loss, dehydration, 3rd space lost

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2
Q

What are renal causes of acute renal failure

A 
Haemolytic uraemic syndrome
Anaemia (haemolysis) 
Thrombocytopaenia 
Uraemia 
E Coli 0157 - through diet or touching animals
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3
Q

What are post renal causes of acute renal failure

A

Obstruction - abdominal masses, renal tumours, constipation

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4
Q

End stage renal failure is (common/uncommon/never happens) in children

A

Uncommon

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5
Q

What can cause ESFR in children

A

Structural abnormalities
Nephritis
Haemolytic uraemic syndrome

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6
Q

How might ESFR present in paediatrics

A

Anorexia
Poor growth
Hypertension
Can present as an emergency

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7
Q

Most children will receive a transplant before needing dialysis (T/F)

A

False, some children may have a pre-emptive transplant, but most start of dialysis

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8
Q

What types of dialysis are available

A

Peritoneal dialysis

Haemodialysis

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9
Q

What proportion of children needing dialysis will have peritoneal dialysis

A

2/3

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10
Q

Peritoneal dialysis requires trips to the hospital T/F

A

False

Can be done at home but requires in dwelling peritoneal catheter

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11
Q

What modes of peritoneal dialysis are there?

A

Overnight cycling - 12 hours on 12 hours off

Continuous ambulatory - small volume, continuous fills

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12
Q

Which mode of peritoneal dialysis is better for older children

A

Continuous ambulatory - less disturbance of lifestyle

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13
Q

What are the potential complications of peritoneal dialysis

A 
Peritonitis
Hernia
Catheter blockage
Tunnel infections 
Ommental blockage
Parental stress/burnout
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14
Q

What is the minimum weight required for haemodialysis

A

10 kg

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15
Q

What is the typical regime for haemodialysis

A

4 hours 3 sessions/week

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16
Q

What access is required for haemodialysis

A

Indwelling catheter
or
Fistula

17
Q

For whom might home haemodialysis be viable

A

Older children with highly motivated families

18
Q

What percentage of children have a relative who can donate a kidney?

A

25%

19
Q

What is the donor mortality rate?

A

0.03%

20
Q

How long will it take for a donor to recover?

A

3 months although their lifetime risk of ESRF will remain slightly elevated

21
Q

What is the age range of donors for a paediatric transplant

A

5-55

22
Q

What is a common condition that can complicate renal transplant if present in the donor and why?

A

Hypertension

Children already have a lower BP than adults, so a hypertensive kidney would be too much of a jump

23
Q

What aspects of the history would cause a kidney donor to be rejected?

A

Malignancy or blood bourne viruses

24
Q

Why might a child with mixed heritage be given a sub-optimal kidney whilst a white child with British heritage would wait for a near-perfect match?

A

The donor pool is much larger for the white child, so more likely to get a good transplant
The mixed heritage causes a complex immunological profile, so may not find a good match in time

25
Q

What is the Z score

A

Used to match kidney to recipient based on degree of match

26
Q

What results in a better quality of life, with reduced mortality and morbidity?
Dialysis / Transplant

A

Transplant

27
Q

What complications can arise from kidney transplant?

A 
Immediate perioperative complications 
Drug side effects 
Immunosupression 
Acute rejection 
Chronic rejection 
Recurrence of underlying renal disease
Post transplant lymphoproliferative disease (PTLD)
28
Q

What causes PTLD

A

It is an EBV driven malignancy

29
Q

What is the 5 year graft survival rate from a living donor

A

87%

30
Q

What is the 7 year graft survival rate from a living donor

A

73%

31
Q

What is the 10 year graft survival rate from a living donor

A

60%

32
Q

What is the 5 year graft survival rate from a deceased donor

A

76%

33
Q

What is the 7 year graft survival rate from a deceased donor

A

60%

34
Q

What is the 10 year graft survival rate from a deceased donor

A

50%

35
Q

When does the incidence of graft loss peak?

A

Adolescence and early adulthood due to compliance and rapid growth

Child health (9 decks)

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