Inborn errors of metabolism
• Unexpected and unexplained clinical deterioration in a previously healthy infant or child is an important clue to the presence of an inborn error of metabolism (IEM). • Loss of…
Biology of the stress response
Pearls • The stress response is a universal, stereotypical, and integrated neurogenic, endocrine, inflammatory, and metabolic systems response with multiple feed-forward and feed-backward modulation signaling designed to maximize host survival….
Cellular respiration
Pearls • Cellular respiration is largely coordinated in the mitochondria and normally aligns energy demand with energy production. In critical illness, disruption of cellular bioenergetic homeostasis may be a final…
Acute severe hypertension
Pearls • Acute severe hypertension, defined as significant blood pressure (BP) elevation with or without evidence of acute hypertensive target-organ damage, requires prompt therapy to prevent and/or ameliorate further target-organ…
Renal pharmacology
Pearls • The kidney is the primary elimination pathway for the majority of medications. Thus, understanding appropriate dosing for patients in acute and chronic renal impairment is imperative to avoid…
Pediatric renal transplantation
Pearls • Kidney transplantation is the treatment of choice for children with end-stage renal disease; children have high priority in the deceased donor allocation policy. • Upon arrival in the…
Pediatric renal replacement therapy in the intensive care unit
Pearls • Patients receiving renal replacement therapy (RRT) require careful monitoring of fluid and electrolyte balance and nutritional needs. • Coordination between the critical care and nephrology staff is essential…
Glomerulotubular dysfunction and acute kidney injury
Pearls • Acute kidney injury (AKI) has replaced the term acute kidney failure . There are more than 30 definitions of AKI in children. Use of the pediatric Risk, Injury,…
Tests of kidney function in children
Pearls • Serum creatinine is a crude assessment of filtration, influenced by several factors other than glomerular function, including gender, age, muscle mass, dilution, concentration relative to steady state, lack…
Renal structure and function
Pearls • Development of the definitive human kidney or metanephros begins at 5 weeks’ gestation and is complete by 34 to 36 weeks’ gestation, with an average of 1 million…
