Renal Flashcards
What can cause false positive protein in UA?
Alkaline urine >7.5
Chlorhexidine antiseptic
Radiocontrast
Coca Cola urine without clots means disease is where?
Upper tract disease (kidney)
Bright red urine with clots means disease is where?
Lower tract disease (ureters, bladder, urethra)
Can have localizing symptoms such as flank pain, freq, or dyslexia
HUS triad
Hemolytic anemia
Thrombocytopenia
Acute renal failure
If suspect HUS, what lab work should you get?
Peripheral smear most helpful to look for schistocytes and burr cells (also minimal platelets)
HSP pts can develop proteinuria how far out?
12 weeks, but commonly do within 4 weeks if they will
Gross painless hematuria with (or days after) an URI
IgA nephropathy : check renal function
Alport syndrome
X-linked disorder
Can present with microscopic hematuria in young boys progressing to hematuria with proteinuria by 10 years and eventually ESRD by AYA
80% develop bilateral deafness
Carriers can have microscopic hematuria
Ketogenic diet can do what to renal system
Predisposes patients to hypercalciuria and stones
Daytime symptoms of overactive bladder with bedwetting over night
Anticholinergic best choice : oxybutynin
most common etiology of abdomen masses in new born period
Multicystic dysplastic kidney
Hydronephrosis due to UPJ obstruction
Renal vein thrombosis, ARPKD, nephroma
When do you do VCUG?
Children >/= 2 febrile UTI Children with 1 febrile UTI and one of the following: - physical abnormalities on US - abnormal pathogen - HTN, poor growth
If has glomerulonephritis what two tests do you need to get?
Check BP and renal function
Fanconi syndrome
Proximal collecting tubule issue: metabolites aren’t reabsorbed
Can result in RTA type 2, rickets
Glycosuria, proteinuria, hypophos, hypoK, non gap MA
POTTER Syndrome
Pulmonary hypoplasia Oligohydramnios Twisted skin (wrinkly) Twisted face (Abel fancies) Extremities defects Renal Agenesis
Ureterocele
Cystic dilation of distal ureter at bladder insertion
5x more common in girls
More likely assoc with duplex collecting system
(In bladder)
If child has urinary stone, what other study should you get?
24 hour urine collection to assess for metabolic disorder
Posterior urethral valves
Only occurs in males
Obstructive uropathy leading to bilateral hydronephrosis
Will have renal dysplasia and tubular damage, making them more susceptible to dehydration
Poststrep glomerulonephritis
Low C3 on labs
Illness a few weeks prior
Most follow C3 to ensure it returns to normal
Flank mass + low platelets + hematuria =
In neonate
Renal vein thrombosis
Can be associated with perinatal asphyxia
Cr >1.5 usually indicates AKI in neonate
Get US
Low C3 Glomerulonephritis
Post infectious/poststrep Membranoproliferative GN Lupus nephritis Shunt nephritis Subacute bacterial endocarditis
Normal C3 Glomerulonephritis
Immunoglobulin A GN HSP ANCA- associated GN Alport syndrome less commonly membranoproliferative
