The USPSTF call to inaction on blood pressure screening in children and adolescents
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 15, 2021 Category: Urology & Nephrology Source Type: research

Flank pain and gross hematuria: an uncommon presentation of a rare disease: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 13, 2021 Category: Urology & Nephrology Source Type: research

Flank pain and gross hematuria: an uncommon presentation of a rare disease:  Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 13, 2021 Category: Urology & Nephrology Source Type: research

Hemodynamic disturbances and oliguria during continuous kidney replacement therapy in critically ill children
ConclusionsThe initiation of CKRT caused hemodynamic instability immediately after initial connection in most patients, but had a beneficial effect on the patient ’s hemodynamic status after 3 h of therapy, presumably owing to decreases in body temperature and heart rate. Urine output significantly decreased in all patients and was not related to negative fluid balance, patient’s hemodynamic status, CKRT settings, or kidney function parameters. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 12, 2021 Category: Urology & Nephrology Source Type: research

Quality improvement goals for pediatric acute kidney injury: pediatric applications of the 22nd Acute Disease Quality Initiative (ADQI) conference
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 12, 2021 Category: Urology & Nephrology Source Type: research

Correction to: Clinical practice recommendations for the diagnosis and management of Alport syndrome in children, adolescents, and young adults –an update for 2020
A Correction to this paper has been published: https://doi.org/10.1007/s00467-020-04892-x (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 12, 2021 Category: Urology & Nephrology Source Type: research

Consensus acute kidney injury criteria integration identifies children at risk for long-term kidney dysfunction after multiple organ dysfunction syndrome
ConclusionsSubstituting KDIGO AKI criteria into existing MODS criteria increases the sensitivity for major adverse kidney events as well as the identification of MODS, improving the detection of children at risk for long-term adverse renal outcomes. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

A rare cause of recurrent acute kidney injury in a 3-year-old girl: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Surprise diagnosis in an adolescent case with chronic kidney damage: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

A rare cause of recurrent acute kidney injury in a 3-year-old girl: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Hypokalemic quadriparesis in a 10-year-old girl: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Thoracic mass lesion in a 14-year-old girl: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Profound metabolic acidosis and hyperammonemia in a 2-year-old child: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Hypokalemic quadriparesis in a 10-year-old girl: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Surprise diagnosis in an adolescent case  with chronic kidney damage: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Profound metabolic acidosis and hyperammonemia in a 2-year-old child: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Thoracic mass lesion in a 14-year-old girl: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 11, 2021 Category: Urology & Nephrology Source Type: research

Urinary biomarkers as point-of-care tests for predicting progressive deterioration of kidney function in congenital anomalies of kidney and urinary tract: trefoil family factors (TFFs) as the  emerging biomarkers
AbstractBackgroundChildren with congenital anomalies of kidney and urinary tract (CAKUT) are at high risk of progressive deterioration of kidney function and further developing stage  5 chronic kidney disease (CKD 5), even after a successful surgery. This prospective study was designed to determine whether urinary biomarkers can predict progressive deterioration of kidney function in children with CAKUT.MethodsThe study included 50 consecutive children, aged
Source: Pediatric Nephrology - January 8, 2021 Category: Urology & Nephrology Source Type: research

Low agreement between kidney volume and kidney length z-scores
This study aims to assess agreement between kidney length and kidney volume z-scores in children.MethodsThis novel cross-sectional cohort study prospectively followed prematurely born babies from a large specialized prematurity follow-up center. A healthy control group matched the cases by age and sex and was recruited from schools. Children were assessed for kidney length and kidney volumes at age 5 by three independent ultrasonographers. All measurements were performed in triplicate. Detailed anthropometry, blood pressure, and kidney function were also obtained. Age-independent z-scores were calculated for all parameters...
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

A rare cause of hypertension in an 11-year-old boy: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

A rare cause of hypertension in an 11-year-old boy: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

An easily overlooked cause of acute kidney injury: Answers
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Response to: Diagnosis of Alport syndrome, is there a role for skin biopsy?
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Diagnosis of Alport syndrome, is there a role for skin biopsy?
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

An easily overlooked cause of acute kidney injury: Questions
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Acute kidney injury and aging
AbstractOur aging population is growing and developing treatments for age-related diseases such as Alzheimer ’s and Parkinson’s disease has taken on an increasing urgency and is accompanied by high public awareness. The already high and rising incidence of acute kidney injury (AKI) in the elderly, however, has received relatively little attention despite the potentially fatal outcomes associated with a n episode of AKI in this age group. When discussing AKI and aging, one should consider two aspects: first, elderly patients have an increased susceptibility to an AKI episode, and second, they have decreased kidn...
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Acute kidney injury in children hospitalized for acute gastroenteritis: prevalence and risk factors
AbstractBackgroundWe aimed to evaluate prevalence of acute kidney injury (AKI) and its risk factors in children hospitalized for acute gastroenteritis (AGE) to identify early predictors of AKI.MethodsWe retrospectively collected clinical and biochemical data of 114 children (57.9% male; mean age 2.9 ± 2.8 years) hospitalized for AGE. AKI was defined according to Kidney Disease/Improving Global Outcomes creatinine criteria. We considered basal serum creatinine as value of creatinine estimated with Hoste (age) equation assuming basal eGFRs were median age-based eGFR normative values for children ≤ 2 years of age, a...
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Sirtuins play critical and diverse roles in acute kidney injury
AbstractAcute kidney injury (AKI) is an extremely common medical affliction affecting both adult and pediatric patients resulting from hypoxic, nephrotoxic, and septic insults affecting approximately 20% of all hospital patients and up to 50% of patients in the intensive care unit. There are currently no therapeutics for patients who suffer AKI. Much recent work has focused on designing and implementing therapeutics for AKI. This review focuses on a family of enzymes known as sirtuins that play critical roles in regulating many cellular and biological functions. There are 7 mammalian sirtuins (SIRT1 –7) that play rol...
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Isolated nocturnal hypertension is associated with increased left ventricular mass index in children
ConclusionsThis study investigated the association between INH and cardiac structure in children with primary and renal HT and showed children with INH had higher LVMI adjusted for age than normotensive children and children with INH had similar LVMI adjusted for age to children with isolated daytime HT. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Outcomes of kidney injury including dialysis and kidney transplantation in pediatric oncology and hematopoietic cell transplant patients
AbstractPediatric oncology and hematopoietic cell transplant (HCT) patients are susceptible to both acute kidney injury (AKI) and chronic kidney disease (CKD). The etiologies of AKI vary but include tumor infiltration, radiation, drug-induced toxicity, and fluid and electrolyte abnormalities including tumor lysis syndrome. HCT patients can also have additional complications such as sinusoidal obstructive syndrome, graft-versus-host disease, or thrombotic microangiopathy. For patients with severe AKI requiring dialysis, multiple modalities can be used successfully, although continuous kidney replacement therapy (CKRT) is of...
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

24-hour ambulatory blood pressure monitoring 9 years after pediatric cardiac surgery: a pilot and feasibility study
ConclusionOur pilot study determined that ABPM was feasible in children years after cardiac surgery and frequently identified ABPM abnormalities. Future research in larger populations is needed to define specific risk factors for HTN in children after cardiac surgery. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Reduced urinary excretion of neutrophil gelatinase-associated lipocalin as a risk factor for recurrence of febrile urinary tract infection in children
This study aimed to test the hypothesis that reduced urinary excretions of neutrophil gelatinase-associated lipocalin (NGAL) predispose children to recurrence of febrile urinary tract infection (fUTI).MethodsSubjects were 38 children diagnosed with fUTI. To examine risk factors for recurrence of fUTI, the subjects were divided into a non-recurrent group and a recurrent group according to the presence or absence of fUTI over 3 years since the first episode. We measured the urinary NGAL levels in patients with fUTI at the non-infected stage in addition to age-matched healthy control children.ResultsIn a multiple logistic reg...
Source: Pediatric Nephrology - January 7, 2021 Category: Urology & Nephrology Source Type: research

Promising biomarkers in pediatric chronic kidney disease through the kaleidoscope of CAKUT background complexity
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 6, 2021 Category: Urology & Nephrology Source Type: research

Monitoring dialysis adequacy: history and current practice
AbstractDialysis adequacy for pediatric patients has largely followed the trends in adult dialysis by judging the success or adequacy of peritoneal or hemodialysis with urea kinetic modeling. While this provides a starting point to establish a dose of dialysis, it is clear that urea is only part of the picture. Many clinical parameters and interventions now have been identified that are just as impactful on mortality and morbidly as urea clearance. As such, our concept of adequacy is evolving to include non-urea parameters and assessing the impact that following an “adequate therapy” has on patient lives. As we...
Source: Pediatric Nephrology - January 5, 2021 Category: Urology & Nephrology Source Type: research

Acute peritoneal dialysis, complications and outcomes in 389 children with STEC-HUS: a multicenter experience
ConclusionsAcute PD was a safe and effective method to manage AKI in children with STEC-HUS. Prophylactic antibiotics prior to insertion of the PD catheter should be considered to decrease the incidence of peritonitis. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 4, 2021 Category: Urology & Nephrology Source Type: research

Distribution of proteinuria- and albuminuria-to-creatinine ratios in preterm newborns
ConclusionsWe report distribution of proteinuria- and albuminuria-to-creatinine in preterm newborns, including the upper-limit values. These values should be taken into account in the detection and diagnosis of glomerular disease and/or injury in daily clinical practice.Graphical abstract (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 4, 2021 Category: Urology & Nephrology Source Type: research

Biomarkers in pediatric glomerulonephritis and nephrotic syndrome
AbstractGlomerular diseases are often chronic or recurring and thus associated with a tremendous physical, psychological, and economic burden. Their etiologies are often unknown, and their pathogeneses are frequently poorly understood. The diagnoses and management of these diseases are therefore based on clinical features, traditional laboratory markers, and, often, kidney pathology. However, the clinical presentation can be highly variable, the kidney pathology may not establish a definitive diagnosis, and the therapeutic responses and resulting clinical outcomes are often unpredictable. To try to address these challenges...
Source: Pediatric Nephrology - January 3, 2021 Category: Urology & Nephrology Source Type: research

Effect of levocarnitine supplementation on myocardial strain in children with acute kidney injury receiving continuous kidney replacement therapy: a pilot study
AbstractBackgroundCarnitine plays a key role in energy production in the myocardium and is efficiently removed by continuous kidney replacement therapy (CKRT). Effects of levocarnitine supplementation on myocardial function in children receiving CKRT have not been investigated.MethodsThis controlled pilot cohort study of 48 children investigated effects of levocarnitine supplementation on myocardial strain in children receiving CKRT for acute kidney injury (AKI). Children (n = 9) with AKI had total (TC) and free plasma carnitine (FC) measurements and echocardiogram for longitudinal and circumferential strain at baseline (p...
Source: Pediatric Nephrology - January 3, 2021 Category: Urology & Nephrology Source Type: research

Non-invasive continuous renal tissue oxygenation monitoring to identify preterm neonates at risk for acute kidney injury
AbstractBackgroundNear-infrared spectroscopy (NIRS) is an emerging tool to identify signs of inadequate tissue oxygenation in preterm neonates with acute kidney injury (AKI). Previous studies have shown a correlation between low renal tissue oxygenation (RrSO2) in the first 24  hours of age and the later development of AKI. In this prospective clinical trial, NIRS monitoring was used to identify changes in RrSO2 in comparison to traditional AKI markers, serum creatinine (SCr), and urine output (UOP).MethodsWe enrolled 35 preterm neonates born less than 32  weeks’ gestation and applied neonatal NIRS sensors ...
Source: Pediatric Nephrology - January 3, 2021 Category: Urology & Nephrology Source Type: research

Neutrophil gelatinase-associated lipocalin for urinary tract infection and pyelonephritis: a systematic review
ConclusionsUrinary NGAL appears promising for the diagnosis of UTI; however, larger studies are needed to validate this marker as a replacement for leukocyte esterase. The use of NGAL for diagnosing acute pyelonephritis requires further study. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 3, 2021 Category: Urology & Nephrology Source Type: research

Infantile urolithiasis
(Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 2, 2021 Category: Urology & Nephrology Source Type: research

Glomerular involvement in children with H syndrome
ConclusionsGeneralized peripheral pitting edema and glomerulopathy broaden the clinical spectrum of H syndrome. Periodic bloodwork and urinalysis are recommended.Graphical abstract (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 2, 2021 Category: Urology & Nephrology Source Type: research

First-week urine beta-2 microglobulin levels in term healthy neonates
ConclusionsFirst-week urinary β2mG levels in healthy term infants were higher than adult levels. Incomplete maturation of kidney tubules in neonates could be a possible explanation. These can now be used in clinical practice and further studies that assess the degree of proximal tubular function in health and disease.Graphical abstract (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 2, 2021 Category: Urology & Nephrology Source Type: research

Tumor necrosis factor-alpha is associated with mineral bone disorder and growth impairment in children with chronic kidney disease
ConclusionsTNF- α is positively associated with biomarkers of CKD-MBD and inversely associated with heightz-score, indicating that inflammation likely contributes to the development of CKD-MBD and growth impairment in pediatric CKD. Prospective studies to definitively assess causative effects of inflammation on bone health and growth in children with CKD are warranted. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 2, 2021 Category: Urology & Nephrology Source Type: research

Dietary fibre intake is low in paediatric chronic kidney disease patients but its impact on levels of gut-derived uraemic toxins remains uncertain
ConclusionsFibre intake in paediatric CKD is low and is even worse in advanced CKD stages. Current dietary fibre recommendations for healthy children are not being achieved. Dietary management of CKD is complex in which too restrictive diets carry the risk of nutritional deficiencies. The relation of fibre intake with PBUTs remains unclear and needs further investigation.Graphical abstract (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - January 2, 2021 Category: Urology & Nephrology Source Type: research

Mitochondrial DNA mutations in renal disease: an overview
AbstractKidneys have a high energy demand to facilitate the reabsorption of the glomerular filtrate. For this reason, renal cells have a high density of mitochondria. Mitochondrial cytopathies can be the result of a mutation in both mitochondrial and nuclear DNA. Mitochondrial dysfunction can lead to a variety of renal manifestations. Examples of tubular manifestations are renal Fanconi Syndrome, which is often found in patients diagnosed with Kearns-Sayre and Pearson ’s marrow-pancreas syndrome, and distal tubulopathies, which result in electrolyte disturbances such as hypomagnesemia. Nephrotic syndrome can be a glo...
Source: Pediatric Nephrology - November 30, 2020 Category: Urology & Nephrology Source Type: research

Acute kidney injury among hospitalized children with cancer
ConclusionsAKI events are common among Chinese children hospitalized for cancer and are associated with adverse in-hospital outcomes. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - November 30, 2020 Category: Urology & Nephrology Source Type: research

Be aware of acute kidney injury in critically ill children with COVID-19
ConclusionsCritically ill children with COVID-19 may develop AKI, especially following prodromal gastrointestinal symptoms. An inflammatory storm and complement-mediated injury may underlie AKI development in children with COVID-19. Our study supports implantation of PE and CKRT in management of critically ill patients with AKI. (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - November 30, 2020 Category: Urology & Nephrology Source Type: research

Delivery of a nutritional prescription by enteral tube feeding in children with chronic kidney disease stages 2 –5 and on dialysis—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce
We present CPRs for delivery of the nutritional prescription via enteral tube feeding to children with chronic kidney disease stages 2–5 and on dialysis. We address the types of enteral feeding tubes, when they should be used, placement techniques, recommendations and contraindications for their use, and evidence for their effects on growth parameters. Statements with a low grade of evidence, or based on opinion, must be considered and adapted for the individual patient by the treating physician and dietitian according to their clinical judgement. Research recommendations have been suggested. The CPRs will be regular...
Source: Pediatric Nephrology - November 30, 2020 Category: Urology & Nephrology Source Type: research

Cystatin C compared to serum creatinine as a marker of acute kidney injury in critically ill neonates
ConclusionsCysC may be used as a screening biomarker of AKI in critically ill neonates; yet, it was not superior to serum creatinine.Graphical abstract (Source: Pediatric Nephrology)
Source: Pediatric Nephrology - November 30, 2020 Category: Urology & Nephrology Source Type: research