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The first 25 slides, exactly as they appear. The full deck has 72 content slides.
Paediatric Surgery
Chronic Kidney Disease
Built from Puri — Pediatric Surgery and Pediatric Urology
What’s inside
9 sections · 72 slides
Overview
- What this deck teaches you
What Is Chronic Kidney Disease?
Definitions, and why children differ
- The core idea
- Why children are a special case
- How CKD is defined — the adult template
- Two exceptions that apply only to children
- Three questions the classification asks
- Grading severity by filtration rate (GFR)
- Classifying CKD by its cause
- Grading by how much albumin leaks
Measuring Kidney Function
How we put a number on filtration
- What GFR actually is
- The gold standard, and its stand-ins
- Cystatin C — a blood-based alternative
- The bedside workhorse: the Schwartz formula
- Bedside Schwartz eGFR formula
- How well the bedside formula performs
How Common, and Why
Registries, numbers, and causes
- Where the data come from: registries
- How often CKD occurs
- Who gets it: sex and geography
- Top causes of pediatric CKD in the U.S. (NAPRTCS 2008)
- The big picture on causes
Complications of CKD
Why failing kidneys make the whole body sick
- The kidney does more than make urine
- Anemia — why CKD lowers hemoglobin
- Anemia — the other contributors
- Mineral & bone disorder (CKD-MBD)
- The calcium–phosphate–PTH cascade
- Two key regulators: FGF-23 and calcitriol
- The three faces of renal bone disease (TMV)
- Calcification outside the skeleton
- Bone changes in advanced CKD
- Hypertension in CKD
- Hypertension damages the heart and vessels
- Growth failure — a signature of pediatric CKD
- Metabolic acidosis and its toll on growth
- Malnutrition and growth-hormone resistance
Diagnosis and Evaluation
Finding CKD, staging it, tracking complications
- Staging and the clinical clues
- Laboratory evaluation
- Working up the anemia
- Imaging the kidneys
- Severe hydronephrosis in obstructive nephropathy
- Bilateral grade 5 vesicoureteral reflux
- How often to check bone chemistry (CKD stages 3–5)
- Confirming the type of bone disease
- Cardiovascular evaluation
Treatment of CKD
Fixing each problem to slow the disease and grow the child
- Nutrition — the foundation
- Keeping fluid balance
- Correcting acidosis
- Recombinant growth hormone
- Treating the anemia
- Treating mineral & bone disorder
- The two families of phosphate binder
- Vitamin D therapy
- Cinacalcet for refractory hyperparathyroidism
- Controlling blood pressure
- Other antihypertensive options
Managing End-Stage Kidney Failure
Dialysis and transplantation
- When to move toward dialysis
- Two dialysis modalities
- Choosing a modality
- Renal transplantation — the goal
- What the future holds — counseling families
Bringing It Together
The essentials to remember
- Key takeaways
- References (1/2)
- References (2/2)
- Pediatric Surgery and Pediatric Urology