Childhood Renal/Urological Disorders Flashcards Preview

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Flashcards in Childhood Renal/Urological Disorders Deck (10):

DDx for hematuria in children

Glomerular: glomerulonephritis
Non-glomerular: TICKS (trauma, tumor, infection, cystic disease, congenital obstruction, hyperCalciuria, stones, sickle cell)


pediatric tubulointerstitial disease

proximal tubule: Fanconi's syndrome
LOH: Bartter's syndrome
DCT: Gitelman's syndrome, Gordon's syndrome
CD: Liddle's (Type IV RTA, nephrogenic DI, Liddle's syndrome)


Bartter's disease

renal tubular defect in LOH - like being on chronic high dose loop diuretic
- sodium, Cl-, H20 wasting
- high aldosterone activity --> hypokalemia, metabolic alkalosis
- hypercalciuria


Gitelman's syndrome

renal tubular defect in DT - like being on chronic high dose thiazide diuretics
- sodium chloride wasting (not as bad as Bartter's)
- high aldosterone --> hypokalemia, metabolic alkalosis
- hypermagnesuria --> hypomagnesemia (crave vinegar)
- Hypocalciuria


Gordon's syndrome

opposite of Gitelman's - unregulated Na-Cl cotransporter
- salt and fluid retention --> low renin hypertension
- low aldosterone --> hyperkalemia, metabolic acidosis
tx: thiazide


Liddle's syndrome

renal tubular defect of CD - gain of function mutation of ENaC channel. Autosomal dominant.
- sodium retention --> low renin hypertension
- hypokalemia and metabolic alkalosis
tx: no response to spironolactone, but tx w/ amiloride (direct ENaC antagonist


cystic dysplasia secondary to in utero obstruction

kidney formed normally, but high pressure and severe hydronephrosis in utero -->
- cystic dilation of collecting system
- back pressure --> secondary abnormalities in tubules (nephrogenic DI, type 1 or type 4 RTA, renal insufficiency)


malformations that effect both kidneys

bladder dysfunction
spina bifida
prune belly - weak abdom musculature, undescended testes, etc


cloacal anomaly

disorder in girls
failure of urorectal septum development


bladder outlet obstructions

most common is posterior urethral valves
in utero back pressure --> hydronephrosis and dysplasia
if severe --> Potter's syndrome
tx: surgical ablation of valve, management of renal dysplasia and dysfunctional bladder