By Ron J. Hogg
A much-needed, updated advisor to the medical administration of kidney issues in little ones and kids, this article offers the necessities of analysis and remedy during this very important box, with a sign of while referral to, or session with, the pediatric nephrologist is needed.
With a crew of overseas members who've had an important international effect at the improvement of pediatric nephrology, this trouble-free source takes the findings of experts to a much broader viewers in education and in basic care.
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Additional info for Kidney disorders in children and adolescents: a global perspective of clinical practice
In general, all neonates and infants with a sonographically abnormal bladder, gross dilatation of the upper collecting system, and renal parenchymal abnormalities should undergo a VCUG, as well as infants with cloacal malformation or spinal cord disorders. Followup Page 26 in these patients usually consists of regular US examinations, complemented by dynamic MAG3 renal scintigraphy. Depending on the initial US result, US followup, VCUG (including fistulography or genitography), delayed DMSA or MAG3 scintigraphy, and/or MRI are performed to establish the final diagnosis and monitor the course of the disease.
The most common interventional procedures in the pediatric urinary tract at present are:10,42 • Sonographically guided renal biopsy. • Percutaneous nephrostomy/placement of pigtail/ JJ tubes (combined US+fluoro guidance). • Puncture/drainage of renal abscess as well as some renal cysts (combined US and fluoroscopy guidance, rarely CT). • Arteriography of the renal artery and balloon dilatation/stent implantation in renal artery stenosis or aneurysm. in severe renal bleeding from posttraumatic injury or renal tumors, for treating arteriovenous malformations, or postbiopsy arterio venous fistula (AVF).
27–30 DMSA is extracted from the blood by the proximal tubules and fixed in the tubular cells. 3). g. renal transplant patients. In order to allow gravity to have its full effect, the bladder should be empty when the MAG3 scan is done. 3) Indirect isotope cystography uses the natural filling of the urinary bladder with a labeled tracer by the kidneys: in the late phase of a dynamic MAG3 study an increase of activity in the area of the ureter and/or the renal collecting system indicates VUR. 10,11,31–33 Generally accepted indications for renal isotope studies in pediatric patients are: • Assessment of renal function, particularly for initial diagnosis that can be used as a baseline for followup monitoring of therapeutic measures (DMSA).