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Kidney diseases in children

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“Kidney diseases in children” is a broad topic. It can be organized as:
  1. Congenital and inherited disorders
    • CAKUT: renal agenesis, hypoplasia/dysplasia, obstruction, vesicoureteral reflux
    • Polycystic kidney disease, Alport syndrome, inherited tubular disorders
  2. Glomerular diseases
    • Nephrotic syndrome
    • Acute nephritic syndrome and post-streptococcal glomerulonephritis
    • IgA nephropathy, lupus nephritis, rapidly progressive glomerulonephritis
  3. Urinary tract infection and reflux nephropathy
    • Presentation by age, diagnosis, imaging, treatment, prevention of renal scars
  4. Acute kidney injury
    • Pre-renal, intrinsic renal, and post-renal causes
    • Recognition, fluid/electrolyte issues, initial management
  5. Chronic kidney disease
    • Causes, complications such as anemia, mineral-bone disorder and growth failure
    • Dialysis and transplantation
  6. Tubular and electrolyte disorders
    • Renal tubular acidosis, Fanconi syndrome, Bartter/Gitelman syndromes
    • Sodium, potassium, acid-base, and concentrating defects
  7. Hematuria, proteinuria, hypertension, and edema
    • Practical symptom-based assessment and red flags
  8. Nephrolithiasis and hemolytic uremic syndrome
In practice, children with kidney disease commonly present with edema, frothy or bloody urine, reduced urine output, recurrent fever/UTIs, hypertension, poor growth, or abnormal urine tests. The evaluation usually starts with urinalysis and microscopy, urine culture where relevant, blood pressure, serum creatinine/electrolytes, and renal ultrasound. Urgent review is needed for anuria or oliguria, severe edema or breathing difficulty, high blood pressure with neurologic symptoms, gross hematuria with systemic illness, or suspected acute kidney injury.
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