Paulson Peds Nephro Flashcards
What is the criteria for pediatric CKD?
- GFR <60 for >3 months
- GFR >60 ml/min + evidence of structural damage
What is the mc cause of pediatric CKD?
Congenital disease
What are S/S of pediatric CKD (nonglomerular)?
- Polyuria (large volumes dilute urine)
- Elevated serum Cr
- Poor growth
What are S/S of pediatric CKD (glomerular)?
- Tea or cola colored urine
- -> RBC casts
- Edema
- Elevated BP for age
Best imaging for peds kid with possible CKD?
U/S
Treatment for peds CKD?
- Treat underlying cause
- Prevent/slow progression
- Treat complications
What med is preferred for kids with HTN and proteinuria?
ACEI/ARB
A difference between kids and adults with CKD is that in kids…
You don’t have to limit protein intake whereas in adults you should
What are three common symptoms of CKD?
- Usually start around stage 3
- -Anorexia
- -Fatigue
- -N/V
Once GFR <30, what should you do to treat peds patient with CKD?
- Prepare the family
- Kidney transplant
- 2nd: peritoneal dialysis (in back)
- 3rd: hemodialysis (fistula)
What is the difference between renal dysplasia and renal hypoplasia?
Renal dysplasia = malformed kidneys and they could have cysts (multicystic dysplasia)
Renal hypoplasia= small kidney (by 2 SD)
What is renal agenesis?
-missing a kidney and often ASYMPTOMATIC and found incidentally
What are signs and symptoms of renal dysplasia, hypoplasia or renal agenesis?
Kids that just dont look right
What imaging for renal dysplasia, hypoplasia or renal agenesis?
Renal u/s
Sclerosis (hardening) in parts of at least 1 glomerulous in the entire kidney biopsy specimen when examined histologically
focal segmental glomerulosclerosis
Acute onset of nephrotic syndrome is a finding of what condition?
- Peripheral edema
- Proteinuria
- Hyopalbuminemia
focal segmental glomerulosclerosis
Treatment for HTN + focal segmental glomerulosclerosis?
ACEI/ARB
Treatment for focal segmental glomerulosclerosis + HLD?
Statin/niacin
Pattern of glomerular injury on renal biopsy with characteristic changes on light microscopy
membranoproliferative glomerulonephritis
membranoproliferative glomerulonephritis is similar to _____ in adults
AKI
How to dx membranoproliferative glomerulonephritis?
Renal bx
How to treat mild membranoproliferative glomerulonephritis?
ACEI/ARB
How to dx severe membranoproliferative glomerulonephritis?
Cyclophosphamide or MMF + steroids or rituximab Immunosuppressants
This is the most common cause of nephrotic syndrome in kids?
Minimal change disease
If you see nephrotic syndrome in kids… think of what disease?
Minimal change disease
What are the symptoms of Minimal change disease in kids?
- Fluid in all the wrong spaces so dehydrated internally
- Tachycardia, oliguria, peripheral vasoconstriction, decreased GFR, elevation of renin, aldo and NE
Treatment for Minimal change disease?
Prednisone
Treatment for Minimal change disease if resistant to steroids?
Cyclophosphamide or rituximab
The most common kidney fusion anaomaly that is the cause of various genetic components?
Horshoe kidney
Those with a horseshoe kidney are at increased risk for a _________ tumor
Wilms tumor
How to dx a horseshoe kidney?
U/S
How to treat a horseshoe kidney?
Most do fine without intervention but if have VUR then consider prophylactic abx
