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Pediatric Clinics of North America

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https://www.readbyqxmd.com/read/30454756/dedication-to-julie-rich-ingelfinger
#1
EDITORIAL
James C Chan
No abstract text is available yet for this article.
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454755/dealing-with-the-challenges-of-the-good-fortune-of-an-abundance-of-new-knowledge
#2
EDITORIAL
Bonita F Stanton
No abstract text is available yet for this article.
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454754/clinical-disorders-of-the-kidney
#3
EDITORIAL
James C Chan
No abstract text is available yet for this article.
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454753/lupus-nephritis
#4
REVIEW
Scott E Wenderfer, Karen W Eldin
Childhood-onset systemic lupus erythematosus (SLE) is a subset of SLE with an onset before 18 years of age. Patients with early onset SLE tend to have a greater genetic component to their disease cause, more multisystemic involvement, and a more severe disease course, which includes greater risks for developing nephritis and end-stage kidney disease. Five- and 10-year mortality is lower than in adult-onset SLE. Although patient and renal survival have improved with advances in induction and maintenance immunosuppression, accumulation of irreversible damage is common...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454752/nephrotic-syndrome
#5
REVIEW
Chia-Shi Wang, Larry A Greenbaum
Nephrotic syndrome is characterized by edema, proteinuria, hypoalbuminemia, and hyperlipidemia. Minimal change disease, the most common cause in childhood, generally responds to corticosteroids, although most patients experience disease relapses. Focal segmental glomerulosclerosis is usually resistant to corticosteroids and carries a significant risk of kidney failure, necessitating renal transplantation. Nephrotic syndrome may also be secondary to gene mutations and systemic diseases such as lupus. Clinical evaluation involves distinguishing primary and secondary causes and monitoring for disease complications, including blood clots and serious infections such as spontaneous bacterial peritonitis...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454751/infection-related-glomerulonephritis
#6
REVIEW
Elizabeth A K Hunt, Michael J G Somers
Acute postinfectious glomerulonephritis or infection-related glomerulonephritis has been associated with several viral or bacterial infections. Group A beta-hemolytic streptococcal infection is the prototypical cause of postinfectious glomerulonephritis and the main focus of this discussion. The clinical spectrum can vary widely, from asymptomatic microscopic hematuria incidentally detected on routine urinalysis to rapidly progressive glomerulonephritis with acute kidney injury requiring emergent dialysis. Other important causes include glomerulonephritis associated with endocarditis and ventriculoatrial shunt infections...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454750/pediatric-hypertension-diagnosis-evaluation-and-treatment
#7
REVIEW
Monica Guzman-Limon, Joshua Samuels
The etiology of hypertension in children and adolescents is varied; however, the prevalence of pediatric primary hypertension is increasing. Early identification and appropriate management of hypertension in children and adolescents is important to prevent the development of hypertensive end organ disease. The 2017 American Academy of Pediatrics Clinical Practice Guidelines for the Screening and Management of High Blood Pressure in Children and Adolescents provide a comprehensive reference for evaluation and management of hypertension in this age group and should be used when assessing patients with elevated blood pressure and hypertension...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454749/childhood-obesity-and-the-metabolic-syndrome
#8
REVIEW
Edward Nehus, Mark Mitsnefes
Obesity is a leading cause of chronic kidney disease. Children with severe obesity have an increased prevalence of early kidney abnormalities and are at high risk to develop kidney failure in adulthood. The pathophysiology of obesity-related kidney disease is incompletely understood, although the postulated mechanisms of kidney injury include hyperfiltration, adipokine dysregulation, and lipotoxic injury. An improved understanding of the long-term effects of obesity on kidney health is essential treat the growing epidemic of obesity-related kidney disease...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454748/long-term-outcomes-of-kidney-transplantation-in-children
#9
REVIEW
Pamela D Winterberg, Rouba Garro
Kidney transplantation is the preferred treatment for end-stage renal disease (ESRD) in children and confers improved survival, skeletal growth, heath-related quality of life, and neuropsychological development compared with dialysis. Kidney transplantation in children with ESRD results in 10-year patient survival exceeding 90%. Therefore, the long-term management of these patients is focused on maintaining quality of life and minimizing long-term side effects of immunosuppression. Optimal management of pediatric kidney transplant recipients includes preventing rejection and infection, identifying and reducing the cardiovascular and metabolic effects of long-term immunosuppressive therapy, supporting normal growth and development, and managing a smooth transition into adulthood...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454747/chronic-kidney-disease-and-dietary-measures-to-improve-outcomes
#10
REVIEW
Oleh M Akchurin
Chronic kidney disease is an ongoing deterioration of renal function that often progresses to end-stage renal disease. Management goals in children include slowing disease progression, prevention and treatment of complications, and optimizing growth, development, and quality of life. Nutritional management is critically important to achieve these goals. Control of blood pressure, proteinuria, and metabolic acidosis with dietary and pharmacologic measures may slow progression of chronic kidney disease. Although significant progress in management has been made, further research is required to resolve many outstanding controversies...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454746/hemolytic-uremic-syndrome
#11
REVIEW
Ellen M Cody, Bradley P Dixon
Hemolytic uremic syndrome (HUS) is the clinical triad of thrombocytopenia, anemia, and acute kidney injury. Classically associated with enterocolitis from Shiga toxin-producing Escherichia coli, HUS is also associated with Streptococcus pneumoniae infections; genetic dysregulation of the alternative complement pathway or coagulation cascade; and, rarely, a hereditary disorder of cobalamin C metabolism. These share a common final pathway of a prothrombotic and proinflammatory state on the endothelial cell surface, with fibrin and platelet deposition...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454745/nephrogenic-diabetes-insipidus
#12
REVIEW
Catherine Kavanagh, Natalie S Uy
Nephrogenic diabetes insipidus (NDI) results from the inability of the late distal tubules and collecting ducts to respond to vasopressin. The lack of ability to concentrate urine results in polyuria and polydipsia. Primary and acquired forms of NDI exist in children. Congenital NDI is a result of mutation in AVPR2 or AQP2 genes. Secondary NDI is associated with electrolyte abnormalities, obstructive uropathy, or certain medications. Management of NDI can be difficult with only symptomatic treatment available, using low-solute diet, diuretics, and prostaglandin inhibitors...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454744/syndrome-of-inappropriate-antidiuresis
#13
REVIEW
Michael L Moritz
The syndrome of inappropriate antidiuresis (SIAD) is a common cause of hyponatremia in hospitalized children. SIAD refers to euvolemic hyponatremia due to nonphysiologic stimuli for arginine vasopressin production in the absence of renal or endocrine dysfunction. SIAD can be broadly classified as a result of tumors, pulmonary or central nervous system disorders, medications, or other causes such as infection, inflammation, and the postoperative state. The presence of hypouricemia with an elevated fractional excretion of urate can aid in the diagnosis...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454743/hypophosphatemic-rickets
#14
REVIEW
Martin Bitzan, Paul R Goodyer
Hypophosphatemic rickets, mostly of the X-linked dominant form caused by pathogenic variants of the PHEX gene, poses therapeutic challenges with consequences for growth and bone development and portends a high risk of fractions and poor bone healing, dental problems and nephrolithiasis/nephrocalcinosis. Conventional treatment consists of PO4 supplements and calcitriol requiring monitoring for treatment-emergent adverse effects. FGF23 measurement, where available, has implications for the differential diagnosis of hypophosphatemia syndromes and, potentially, treatment monitoring...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454742/update-on-dent-disease
#15
REVIEW
Abdulla M Ehlayel, Lawrence Copelovitch
Dent disease is an X-linked form of chronic kidney disease characterized by hypercalciuria, low molecular weight proteinuria, nephrocalcinosis, and proximal tubular dysfunction. Clinical presentation is highly variable. Male patients may present with early-onset rickets, recurrent nephrolithiasis, or insidiously with asymptomatic proteinuria or chronic kidney disease. Mutations in both the CLCN5 and OCRL1 genes have been associated with the Dent phenotype and are now classified as Dent-1 and Dent-2, respectively...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454741/fanconi-syndrome
#16
REVIEW
John W Foreman
Fanconi syndrome, also known as the DeToni, Debré, Fanconi syndrome is a global dysfunction of the proximal tubule characterized by glucosuria, phosphaturia, generalized aminoaciduria, and type II renal tubular acidosis. Often there is hypokalemia, sodium wasting, and dehydration. In children, it typically is caused by inborn errors of metabolism, principally cystinosis. In adults, it is mainly caused by medications, exogenous toxins, and heavy metals. Treatment consists of treating the underlying cause and replacing the lost electrolytes and volume...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454740/approach-to-the-child-with-hematuria
#17
REVIEW
Denver D Brown, Kimberly J Reidy
The causes of macroscopic and microscopic hematuria overlap; both are often caused by urinary tract infections or urethral/bladder irritation. Coexistent hypertension and proteinuria should prompt investigation for glomerular disease. The most common glomerulonephritis in children is postinfectious glomerulonephritis. In most patients, and especially with isolated microscopic hematuria, the diagnostic workup reveals no clear underlying cause. In those cases whereby a diagnosis is made, the most common causes of persistent microscopic hematuria are thin basement membrane nephropathy, immunoglobulin A nephropathy, or idiopathic hypercalciuria...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454739/renal-tubular-acidosis
#18
REVIEW
Robert Todd Alexander, Martin Bitzan
Renal tubular acidosis should be suspected in poorly thriving young children with hyperchloremic and hypokalemic normal anion gap metabolic acidosis, with/without syndromic features. Further workup is needed to determine the type of renal tubular acidosis and the presumed etiopathogenesis, which informs treatment choices and prognosis. The risk of nephrolithiasis and calcinosis is linked to the presence (proximal renal tubular acidosis, negligible stone risk) or absence (distal renal tubular acidosis, high stone risk) of urine citrate excretion...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454738/bartter-syndrome-and-gitelman-syndrome
#19
REVIEW
Rosanna Fulchiero, Patricia Seo-Mayer
Bartter and Gitelman syndromes are conditions characterized by renal salt-wasting. Clinical presentations range from severe antenatal disease to asymptomatic with incidental diagnosis. Hypokalemic hypochloremic metabolic alkalosis is the common feature. Bartter variants may be associated with polyuria and weakness. Gitelman syndrome is often subtle, and typically diagnosed later life with incidental hypokalemia and hypomagnesemia. Treatment may involve fluid and electrolyte replenishment, prostaglandin inhibition, and renin-angiotensin-aldosterone system axis disruption...
February 2019: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/30454737/tubulointerstitial-nephritis
#20
REVIEW
Rebecca L Ruebner, Jeffrey J Fadrowski
Tubulointerstitial nephritis (TIN) is a cause of acute kidney injury in children characterized histologically by an inflammatory cell infiltrate in the kidney interstitium. The most common causes of TIN in children include medications, infections, inflammatory disorders, and genetic conditions. TIN typically presents with nonoliguric acute kidney injury and may be associated with systemic symptoms, including fever, rash, and eosinophilia. The long-term prognosis is generally favorable, with full kidney recovery; however, some patients may develop progressive chronic kidney disease...
February 2019: Pediatric Clinics of North America
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