📋 Paediatrics
Acute Kidney Injury and Chronic Kidney Disease in Paediatrics Complete Clinical Guide
Learn Acute Kidney Injury and Chronic Kidney Disease in paediatrics including causes, pathophysiology, clinical features, diagnosis, staging, complications, and treatment. A detailed guide for medical students, paediatricians, and healthcare professionals.
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Frequently Asked Questions
❓ What is acute kidney injury in paediatrics?
Acute kidney injury (AKI) in paediatrics is a sudden decline in kidney function occurring over hours to days, resulting in reduced glomerular filtration rate, accumulation of waste products such as urea and creatinine, electrolyte imbalance, and decreased urine output.
❓ What are the most common causes of acute kidney injury in children?
The most common causes include prerenal conditions such as dehydration and shock, intrinsic renal causes such as hemolytic uremic syndrome and acute tubular necrosis, and postrenal causes such as urinary tract obstruction including posterior urethral valves.
❓ What are the typical symptoms of acute kidney injury in paediatric patients?
Common symptoms include decreased urine output, swelling of the face and limbs, vomiting, fatigue, high blood pressure, electrolyte imbalance, and in severe cases seizures or altered consciousness.
❓ How is acute kidney injury diagnosed in children?
Diagnosis is based on rising serum creatinine, reduced urine output, abnormal electrolyte levels, urinalysis findings, and imaging studies such as renal ultrasound to identify structural abnormalities or obstruction.
❓ What is chronic kidney disease in paediatrics?
Chronic kidney disease (CKD) in paediatrics is a progressive and irreversible loss of kidney function lasting longer than three months, characterized by reduced glomerular filtration rate or evidence of structural kidney damage.
❓ What are the major causes of chronic kidney disease in children?
Common causes include congenital anomalies of the kidney and urinary tract, hereditary kidney diseases such as Alport syndrome and polycystic kidney disease, chronic glomerulonephritis, reflux nephropathy, and obstructive uropathy.
❓ What are the stages of chronic kidney disease in children?
CKD is classified into five stages based on glomerular filtration rate. Stage 1 has normal GFR with kidney damage, while Stage 5 represents end-stage renal disease with GFR less than 15 ml per minute per 1.73 m².
❓ What complications can occur in children with chronic kidney disease?
Complications include anemia due to reduced erythropoietin production, growth retardation, renal osteodystrophy, hypertension, electrolyte imbalance, metabolic acidosis, and cardiovascular disease.
❓ How is chronic kidney disease treated in paediatric patients?
Treatment focuses on managing the underlying cause, controlling blood pressure with medications such as ACE inhibitors, correcting anemia with erythropoietin, managing bone disease with vitamin D and phosphate binders, nutritional therapy, and renal replacement therapy when needed.
❓ What is the definitive treatment for end-stage kidney disease in children?
Kidney transplantation is the definitive treatment for end-stage renal disease in children, providing better long-term survival and quality of life compared to long-term dialysis.