A 12-year-old girl is admitted to general paediatrics with fever, malaise and pain in the small joints of both hands. Sepsis work-up is negative, and she is referred to paediatric rheumatology for an opinion.
Ella is a 3 year old girl, who presents with bilateral lower leg oedema and facial puffiness. Dipstick of her urine shows 3-4+ of protein. Her BP is normal.
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?
Hypertension
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?