HYPOTHESIS: Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult
In a critically ill patient, fluid balance is imperative in management and maintaining homeostasis. More often than not, patients are resuscitated with fluids to maintain adequate intravascular volume. A common issue seen in pediatric intensive care units is fluid imbalances and hemodynamic instability. Aggressive fluid administration can lead to fluid overload (FO), a condition in
Acute Kidney Injury (AKI) is a common cause of morbidity and mortality globally. According to a study published in the Lancet Journal on ‘incidence and outcomes of neonatal acute kidney injury’, in four countries – India, Canada, USA and Australia, almost one out of every three new-borns when hospitalised for any illness and administered intravenous
Transplantation journal published a recent study from UK, Pediatric ABO incompatible renal transplants. Study showed their 11 children, in comparison to compatible transplants. Our protocol seems to completely same as theirs, with similar outcomes! Image Source
The role of albuminuria as an indicator of progression has not been investigated in children with CKD in the absence of diabetes. An excellent study from Dr Schwartz group from Rochester, on children with CKD shows that the utility of an initial UP/C, ACR, and Unon-alb/cr for characterizing progression is similar.
Persistent hypertension in adulthood is a leading cause of end-stage renal disease (ESRD). Whether lower blood pressure (BP) values, in the range of prehypertension, are also associated with future occurrence of ESRD is unclear. A recent study published in Journal of Hypertension clearly shows that asymptomatic, healthy adolescents with prehypertension have a 32% increased risk
Current issue of CJASN has an excellent review on Nephrotic syndrome written by Dr Emma and his team. It’s a must read for all pediatricians and fellows in nephrology! Minimal change disease (MCD) is a major cause of idiopathic nephrotic syndrome (NS), characterized by intense proteinuria leading to edema and intravascular volume depletion. Image Source
An excellent study from CJASN, Japan published today shows the frequencies of child proteinuria defined as ≥1+ urinary protein were 1.7% in the current smoking group, 1.6% in the past smoking group, and 1.3% in the nonsmoking group. A point to be remembered in infants presenting with proteinuria.
Non-invasive imaging cannot replace formal angiography in the diagnosis of renovascular hypertension
An excellent study published in Pediatric Nephrology journal today from the Great Ormond Street Hospital, UK, shows that the sensitivity of MRA and CTA is still too low to reliably rule out renovascular disease in children with a strong suspicion of this diagnosis. DSA remains the gold standard to diagnose renovascular hypertension and is recommended
Just now saw a child from far away in India, with this MCU showing clearly posterior urethral valves, and now the child is in chronic kidney disease stage V, and requires a transplant. As doctors, we all should spread this message, to diagnose this early and treat it early too fpr better future of these kids!