Blog
April 15, 2020
Consensus guidelines for management of hyperammonaemia in paediatric patients receiving continuous kidney replacement therapy
Hyperammonaemia in children can lead to grave consequences in the form of cerebral oedema, severe neurological impairment and even death. In infants and children, common causes of hyperammonaemia include urea cycle disorders or organic acidaemias. Few studies have assessed the role of extracorporeal therapies in the management of hyperammonaemia in neonates and children. Moreover, consensus
February 22, 2020
Neonatal Acute Kidney Injury: A Survey of Perceptions and Management Strategies Amongst Pediatricians and Neonatologists
Neonatal Acute Kidney Injury (AKI) occurs in 40-70% of critically ill newborn infants and is independently associated with increased morbidity and mortality. Understanding the practice patterns of physicians (neonatologists and pediatricians), caring for neonates in India is important to optimize care and outcomes in neonatal AKI. The aim of this study was to identify differences
February 22, 2020
Renal Replacement Therapy in Pediatric Acute Kidney Injury
Acute kidney injury (AKI) is common in critically ill children and affects nearly 30–40% of patients admitted to the pediatric intensive care unit (ICU). Even with technological advances in critical care and dialysis, there is a high mortality rate of 66.8% to 90% in ICU patients. Renal replacement therapy (RRT) is often performed to treat
February 22, 2020
Pediatric Continuous Renal Replacement Therapy (PCRRT) Expert Committee Recommendation on Prescribing Prolonged Intermittent Renal Replacement Therapy (PIRRT) in Critically Ill Children
Introduction Recently, prolonged intermittent renal replacement therapies (PIRRT) have emerged as cost‐effective alternatives to conventional CRRT and their use in the pediatric population has started to become more prominent. However, there is a lack of consensus guidelines on the use of PIRRT in pediatric patients in an intensive care setting. Methods A literature search was
November 5, 2019
What is nephrotic syndrome and what causes it?
Nephrotic syndrome is disease of the kidneys where the filtering system made of functional units called the nephrons, gets damaged. This is the name given to the collection of findings which develop as a result of such a damage. When the filtering system gets damaged, the kidney tends to filter substances which it usually doesn’t,
November 5, 2019
Idiopathic nephrotic syndrome in children
The incidence of idiopathic nephrotic syndrome (NS) is 1·15-16·9 per 100 000 children, varying by ethnicity and region. The cause remains unknown but the pathogenesis of idiopathic NS is thought to involve immune dysregulation, systemic circulating factors, or inherited structural abnormalities of the podocyte. Genetic risk is more commonly described among children with steroid-resistant disease. The
November 5, 2019
Management of steroid-resistant nephrotic syndrome in children and adolescents
More than 85% of children and adolescents (majority between 1-12 years old) with idiopathic nephrotic syndrome show complete remission of proteinuria following daily treatment with corticosteroids. Patients who do not show remission after 4 weeks’ treatment with daily prednisolone are considered to have steroid-resistant nephrotic syndrome (SRNS). Renal histology in most patients shows presence of
November 5, 2019
Nephrotic Syndrome: Oedema Formation and Its Treatment With Diuretics
Oedema is a defining element of the nephrotic syndrome. Its’ management varies considerably between clinicians, with no national or international clinical guidelines, and hence variable outcomes. Oedema may have serious sequelae such as immobility, skin breakdown and local or systemic infection. Treatment of nephrotic oedema is often of limited efficacy, with frequent side-effects and interactions
November 5, 2019
Genetics of Nephrotic Syndrome Presenting in Childhood
Advances in genome science in the last 20 years have led to the discovery of over 50 single gene causes and genetic risk loci for steroid resistant nephrotic syndrome (SRNS). Despite these advances, the genetic architecture of childhood steroid sensitivenephrotic syndrome (SSNS) remains poorly understood due in large part to the varying clinical course of
November 5, 2019
Kidney disease in children – Nephrotic Syndrome
What is nephrotic syndrome? Nephrotic syndrome as the name suggests is a disease of the kidney which affects the filtering system of the kidney known as the nephrons, which are the small functioning structures within the kidney. These nephrons are damaged due to various causes which results in a set of symptoms, with which the
November 5, 2019
Rituximab Use in the Management of Childhood Nephrotic Syndrome
Childhood nephrotic syndrome is a challenging and often persistent renal disorder, and its incidence varies between different ethnicities and regions. Corticosteroids have been the main treatment for decades and are effective in most children with idiopathic NS, although 10-15% of these children become steroid resistant. Furthermore, some initially steroid sensitive children follow a steroid dependent
November 5, 2019
How does Prednisolone Work in Nephrotic Syndrome?
Nephrotic syndrome (NS), a common chronic kidney disease, embraces a variety of kidney disorders. Though Glucocorticoids (GCs) are generally used in the treatment of NS, their mechanism of action is poorly understood. A plethora of evidence indicates that podocytes are considered as the main target cells for the therapeutic strategies to prevent NS. GCs regulate