SM 217a - Pediatric Nephrology

Question 1

What are the 4 most common CAKUT diagnoses?

Answer 1

• Hydronephrosis (most common)
  
  • +/- obstruction, vesicoureteral reflux (VUR)
• Renal cysts
• Renal dysplasia
  
  • +/- hydronephrosis and/or cysts
• Renal agenesis

Question 2

What causes aplasia?

Answer 2

Failure of the ureteric bud to induce the metanephric mesenchyme

Question 3

When in gestation do the first glomeruli form?

Answer 3

9-10 weeks

Question 4

How do the causes of CKD differ between adult and pediatric patients?

Answer 4

• Pediatric
  
  • 36% of ESKD is from CAKUT
• Adults
  
  • DM and HTN are common causes

Question 5

What is the most common CAKUT diagnosis?

Answer 5

Hydronephrosis

May resolve over time, may not

Question 6

Which acute GNs present with low complement levels?

Answer 6

Post-infectious GN

MPGN

Lupus nephritis

Question 7

Outgrowth of the _____ forms the ureteric bud

Answer 7

Outgrowth of the mesonephric/wolffian duct forms the ureteric bud

Question 8

What are the most common causes of CKD in children?

Answer 8

• Aplasia/hypoplasia/dysplasia =16%
• Obstructive Uropathy = 15%
• Focal Segmental Glomerulosclerosis =12%
• Reflux Nephropathy =5%
• Polycystic Kidney Diseases = 3%
• Other Chronic GN= 3%

For comparison, in adults:

• Diabetic nephropathy
• HTN
• ADPKD (usually does not present in childhood)

Question 9

What acute GNs present with normal complement levels?

Answer 9

IgA Nephropathy

ACNA-accociated GN (Pauci-immune)