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Introduction to Pediatric Nephrology PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Introduction to Pediatric Nephrology" by Dr.Fahad Gadi, MD.

This medical PowerPoint presentation is about Pediatric Nephrology, a branch of medicine that deals with the diagnosis and treatment of kidney-related diseases in children, including infants, toddlers, and adolescents. The kidneys play an essential role in removing waste and excess fluids from the body, regulating electrolytes and blood pressure, and producing hormones that control red blood cell production and bone health.

Pediatric nephrologists are specialized doctors who work with children who have kidney diseases or disorders that affect the kidneys. These disorders may include urinary tract infections, nephrotic syndrome, hematuria (blood in the urine), kidney stones, chronic kidney disease, and congenital abnormalities of the kidney and urinary tract.

Pediatric nephrologists work closely with other medical professionals, such as pediatricians, urologists, radiologists, and surgeons, to provide comprehensive care for children with kidney disorders. They may use a variety of diagnostic tools, including blood tests, urine tests, imaging studies, and biopsies, to diagnose and treat kidney diseases.

Treatment options for kidney diseases in children may include medications, dietary changes, and dialysis or kidney transplantation in severe cases. Pediatric nephrologists work with families to develop a personalized treatment plan that meets the unique needs of each child.

Overall, pediatric nephrology plays an important role in helping children with kidney diseases and disorders achieve optimal health and well-being.

Tags : Pediatric Nephrology, kidney-related diseases in children, urinary tract infections, nephrotic syndrome, hematuria, kidney stones, chronic kidney disease, congenital abnormalities of the kidney and urinary tract, Pediatrics, Pediatrics PowerPoint presentation

Published on : Jun 23, 2023 | Views : 1193 | Downloads : 0

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Slide 1-

Introduction to Pediatric Nephrology Dr.Fahad Gadi, MD Pediatrics Demonstrator King Abdulaziz University Rabigh Medical School
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Kidney ontogenesis The embryological development of the kidney is a long and continuous process which begins in the 3rd week and is completed by about 34-35 weeks of fetal life. Kidney organogenesis is characterised by 3 distinct and linked stages: pronephros, mesonephros and metanephros.
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Kidney ontogenesis In humans, the first two are transient structures with little excretory capacity but they are important for the appropriate development of the metanephros, which is the direct precursor of the adult kidney.
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METANEPHROS The final stage of the kidney is the differentation of the metanephros and arise from the ureteric bud and the metanephric blastema (mesenchyme). The renal pelvis, major and minor calyces and terminal collecting duct are formed by the 10-13th wks of ges. After morphogenesis each kidney contains approx a million nephrons.
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Renal development 3 t.ż. 4-8 t.ż. 5 t.ż. nefrotomy przewód Wolffa Przednercze Śródnercze Nerka ostateczna stek aorta pączek moczowodowy blastema nerki ostatecznej Pronephros Mesonephros Metanephros
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Antenatal Period The most common cause is physiologic dilation. Metanephric urine production begins at 8 weeks, even before ureteral canalization is complete. Transient obstruction with hydronephrosis occurs.
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Embryology
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MOLECULAR ASPECT The development of the metanephric kidney depends on inductive interaction between the ureteric bud (UB) and the metanephric mesenchyme (MM). A large number of genes have been found to be crucial during kidney development.
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Nephrons In the fetus at 36 weeks’ gestation there is an adult complement of nephrons- approx. one million All further growth of the kidney is via hyperplasia mainly in the tubules.
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Fetal kidney Nephrogenesis is completed between the 28 and 36th gestational week in the human, the renal tissue and particularly the tubular cells continue to develop postnatally. Several of the major transporters in the tubular epithelial cells undergo postnatal maturation
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Fetal kidney Outer cortical glomeruli are relatively underperfused compared with inner cortical glomeruli. Following birth, renal perfusion to superficial cortical nephrons rises compared with deeper glomeruli
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Fetal kidney Angiotensin-converting enzyme inhibitors and angiotensin-receptor antagonists impair nephrogenesis and so are contraindicated in pregnancy
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Production of urine Production of urine starts at the age of 10-12 weeks of gestation: 1. very dilute urine 2. small amount of urine Fetal urine is a major constituent of amniotic fluid and urinary flow rate increases from 12ml/hr at 32 weeks’gestation to 28ml/hr at 40 weeks’gestation. Similar increases are described during the maturation of premature newborns.
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Glomerular Filtration Rate (GFR) Glomerular filtration begins between the 9th and 12th week of gestation in humans. The GFR is relatively low at birth especially in the premature infant. The values of GFR nearly double between 3 and 7 days and thereafter GFR continues to increase, by 1 to 2 yrs of age the GFR is the same as in an older child- 80% of mature kidney.
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GFR
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Kidney of newborn The kidney of the newborn infant has a limited capacity to regulate the excretion of fluid and electolytes. The high sodium excretion during the first 2 to 3 weeks often results in a negative sodium balance and predisposes to hyponatremia.
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Creatinine Clearance Newborn: 40-65 ml/min/1.73 m2 <40 yrs: 97-137 ml/min/1.73 m2
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Renal failure in the newborn Renal failure in the newborn: severe asphyxia, the majority suffered from nonoliguric renal failure
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CAKUT Congenital Anomalies of Kidney and Urogenital Tract
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CAKUT Chronic renal failure (children): Obstructive nephropathy- 47% Reflux nephropathy- 18,5% Hypo/dysplasia 8,7%
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RENAL ABNORMALITIES Renal agenesis: bilateral fetal death- Potter syndrome 1:4000 pregnancies unilateral other organ- 1:2900 pregnancies abnormalites
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Agenesis Aplasia Hypoplasia Renal abnormalities
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RENAL ABNORMALITIES Hydronephrosis
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RENAL ABNORMALITIES Obstractive uropathy: A. ureteropelvic junction obstruction- dilated renal pelvis with/ without caliectasis and no dilation of the ureter B. ureterovesical junction obstruction (megaureter)- pelviectasis and caliectasis with significant ureter dilation
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RENAL ABNORMALITIES C. posterior urethral valve D. ureterocele- cystic dilatation of the distal ureter that protrudes into the urinary bladder, may extend past the bladder into urethra E. ectopic ureters F. constriction (stenosis)of urethra
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Type I – Type II Type III Posterior urethral valve
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Duplication of urinary tract Ureter Ureter Ureter duplex fissus
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Frequency of VUR • Isolated 1% (0.4-4%) • UTI in the past 29-50% • Siblings with VUR 32-45% • Mothers with VUR in the past 60% Vesico-ureteral reflux
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RENAL ABNORMALITIES Polycystic kidney: autosomal dominant p.k.disease autosomal recessive p.k. disease
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Kidney ontogenesis
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PRONEPHROS Pronephros is a transitory non-functional kidney, the first tubules appear the middle of the 3rd week and arise from intermediate mesodermal cells. The pronephric tubules persist for only a short time and undergo degeneration by the 5th week. At the time the pronephros is degenerating the mesonephric tubules and duct are developing.
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Pronephros
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Vesico- ureteral reflux Normal kidney, ureter, and bladder
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Vesico- ureteral reflux Grade I Vesicoureteral Reflux:urine (shown in blue) refluxes part-way up the ureter
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Vesico- ureteral reflux Grade II Vesicoureteral Reflux:urine refluxes all the way up the ureter
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Vesico- ureteral reflux Grade III Vesicoureteral Reflux:urine refluxes all the way up the ureter with dilatation of the ureter and calyces (part of the kidney where urine collects)
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Vesico- ureteral reflux Grade IV Vesicoureteral Reflux:urine refluxes all the way up the ureter with marked dilatation of the ureter and calyces
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Vesico- ureteral reflux Grade V Vesicoureteral Reflux:massive reflux of urine up the ureter with marked tortuosity and dilatation of the ureter and calyces
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Io IIo IIIo IVo Vo International Classification of VUR