Kidney Kids

Learn how pediatric high blood pressure is being missed in busy clinics, why obesity is driving more primary hypertension, and how to properly interpret readings using the 2017 AAP guidelines. The episode also covers ABPM confirmation, red-flag features for secondary causes, and the recommended workup and safety checks before treatment.

Hematuria is a common reason for pediatric nephrology referral, but distinguishing glomerular from non-glomerular causes is the key to building the right differential. In this episode, we walk through a practical approach to pediatric hematuria, beginning with confirmation by urine microscopy and then using urine color, red blood cell morphology, proteinuria, blood pressure, and kidney function to...

A 4-year-old presents with puffy eyes and foamy urine. In this episode, we review the clinical presentation, key definitions, pathophysiology, initial workup, and biopsy considerations for pediatric nephrotic syndrome. Topics include steroid-sensitive, steroid-resistant, frequently relapsing, and steroid-dependent nephrotic syndrome; podocyte injury; immune dysregulation; anti-nephrin autoantibodi...

Bartter and Gitelman syndromes are inherited renal salt-wasting disorders that share many laboratory features but differ in their underlying physiology, clinical presentation, and management. In this episode, we compare these two important tubulopathies using a practical nephron-based approach to help learners understand—not just memorize—their key differences. Topics include the physiology of the...

Renal tubular acidosis (RTA) is an important cause of normal anion gap metabolic acidosis in children and should be considered in infants presenting with failure to thrive, vomiting, poor growth, nephrocalcinosis, or persistent electrolyte abnormalities. In this episode, we review the physiology of renal acid-base handling, distinguish the major forms of pediatric RTA, and develop a practical beds...

Hypernatremia can be deceptively difficult to recognize in children, and correcting sodium disorders too quickly can have devastating neurologic consequences. In this episode, we discuss the evaluation and management of pediatric hypernatremia, including neonatal hypernatremic dehydration, central and nephrogenic diabetes insipidus, the post-neurosurgical triphasic response, and practical approach...

A child develops headache, vomiting, and confusion after receiving hypotonic IV fluids following surgery. Is this true hyponatremia? Could it be pseudohyponatremia? Or is there another explanation? In this episode of Kidney Kids: A Guide to Pediatric Nephrology, we explore the evaluation of pediatric hyponatremia, including pseudohyponatremia, hypertonic hyponatremia in diabetic ketoacidosis, and...

Hemodialysis can seem intimidating at first, but understanding the core principles makes it much easier to approach at the bedside. In this episode, we break down how pediatric hemodialysis works using simple analogies while exploring the clinical concepts every pediatric trainee should know. Topics include diffusion, ultrafiltration, convection, the dialyzer, vascular access, dialysis adequacy (K...

Once acute kidney injury is recognized, early management can significantly influence both short- and long-term outcomes. In this episode, we discuss the principles of pediatric AKI management, including fluid resuscitation, hyperkalemia, metabolic acidosis, fluid overload, indications for renal replacement therapy, and the unique considerations when choosing a dialysis modality in children. We als...

A rising creatinine can be one of the most stressful calls a pediatric trainee receives overnight. In this episode, we walk through a practical, step-by-step approach to evaluating pediatric acute kidney injury, from the bedside history and physical examination to laboratory testing, urine microscopy, imaging, and knowing when to involve pediatric nephrology. Topics include interpretation of urine...

Acute kidney injury (AKI) is one of the most common and potentially life-threatening conditions encountered in pediatric medicine. In this episode, we review how to recognize AKI using the KDIGO criteria, estimate baseline kidney function when no prior creatinine is available, and develop a practical framework for identifying the underlying cause. Topics include prerenal, intrinsic, and postrenal...

Chronic kidney disease in children is fundamentally different from CKD in adults. In this episode, we review how pediatric CKD is defined and staged, why congenital anomalies of the kidney and urinary tract (CAKUT) remain the leading cause of childhood CKD, and how kidney function should be estimated across different pediatric age groups. We also discuss common causes of pediatric CKD, the importa...

Managing pediatric chronic kidney disease extends far beyond monitoring kidney function. In this episode, we discuss evidence-based strategies to slow CKD progression, including blood pressure control, RAAS inhibition, and the treatment of common complications such as metabolic acidosis, CKD-mineral bone disorder, growth failure, and anemia. We also review the role of ambulatory blood pressure mon...

Children with chronic kidney disease have unique nutritional and developmental needs that differ significantly from adults. In this episode, we discuss evidence-based nutritional management, growth failure, recombinant human growth hormone therapy, neurocognitive outcomes, and the role of school support for children living with CKD. We also review the timing of kidney replacement therapy, the bene...