Neonatal Kidney Conditions

Question 1

urine is the contributor to amniotic fluid beyond 40 weeks ..?

Answer 1

Beyond 20 weeks’ gestation, urine is the contributor to 80% of the amniotic fluid.

Thus, oligohydramnios or polyhydramnios beyond this gestational age reflects dysfunction of the developing kidney.

Question 2

Changes in GFR neonates …?

Answer 2

In term babies, GFR rises quickly, doubling by 2 weeks of age and

reaching adult levels by 1 year of age

it takes much longer in preterm babies, as long as 8 years

Question 3

The kidneys regulate GFR by

Answer 3

altering the angiotensin II–induced vasoconstriction at the efferent arteriole and the concurrent prostaglandin-induced vasodilatation at the afferent arteriole to maintain constant renal capillary pressur

Question 4

Age 1–3 days normal GFR …

Answer 4

21 ± 5 (mL/minute/1.73 m2)

Question 5

Reason for limited ability to concentrate urine in newborn due…?

Answer 5

to limited urea concentration within the renal interstitium (because of low protein intake and anabolic growth)

Question 6

The maximal urine concentration (osmolality) is only..?

Answer 6

500 mOsm/L in premature infants and 800 mOsm/L in term infants.

Question 7

The most common cause of delayed or decreased urine production is ..?

Answer 7

Improper recording of the initial void and less commonly inadequate perfusion of the kidneys

Question 8

Side effects of maternal intake if ACE s ARBs or indomethecin …?

Answer 8

decreases glomerular capillary pressure and GFR and interferes with the normal tubular development. This results in a condition called renal tubular dysgenesis which leads to refractory oligoanuric AKI.

Question 9

the common causes of renal mass in neonates

Answer 9

Hydronephrosis and multicystic dysplastic kidney (MCDK)

Question 10

The two types of HD…?

Answer 10

intermittent HDandcontinuous RRT (CRRT), differ mainly by the duration of the procedure.

Intermittent HD is significantly more efficient than CRRT.

The blood flow and time on therapy are the limiting factors for solute clearance on HD.

Question 11

A major risk factor for renal arterial obstruction is….?

Answer 11

umbilical artery catheterization

Question 12

What is high umbilical artery catheter..?

Answer 12

High umbilical artery catheters, placed at the T6 to T10 vertebral level, have been associated with a decreased incidence of clinical vascular complications without a statistically significant increase in any adverse effects

Question 13

T here are three cardinal signs of RVT:…?

Answer 13

macroscopic hematuria, palpable abdominal mass, and thrombocytopenia; these signs have been found in approximately 56%, 45%, and 47% of cases, respectively

Question 14

number of factors are associated with RVT…?

Answer 14

RVT has a male predominance of approximately 67%; it is unilateral in more than 70% of patients and more prevalent on the left side (approximately 63%). The thrombus also involved the inferior vena cava in approximately 43% of the cases, and it was associated with adrenal hemorrhage in approximately 15%