A 3 year old attends the ED with a vomiting illness. Routine observations include a blood pressure measured consistently as 125/80. Should you ignore it?
Definition: acute kidney injury (AKI) is failure of the kidneys to regulate electrolyte, acid-base and fluid homeostasis adequately with concomitant reduction in glomerular filtration rate (GFR). pRIFLE (paediatric Risk, Injury, Failure, Loss, End-Stage Criteria). Chronic renal failure: hyperfiltration, estimated creatinine clearance <75 ml/min/1.73m2 , hypertension, microalbuminuria.
A 5 year old girl is on the ward following a resection of a craniopharyngioma. The nurses call you because her urine output has increased dramatically over the last few hours. You check her Na and it’s 150. Is your brain hurting just thinking about it?
A previously well 3 year old girl presented to your ED with a history of fever. You have confidently diagnosed otitis media and are just about to discharge the child when the nurse mentions a urine was requested at triage and has come back positive for blood.