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Category Archives: Pediatric Issues
My 14 yo grandson is a 2-time cancer survivor. Wilms stage 4 at age 3; came back in peritoneum at age 5. He has one deformed partially functioning kidney. A year ago they found he had reflux to kidney, deformed bladder with scarring. Bladder was repaired. So he was just tested and there is no longer any reflux, his bladder while large has returned to normal shape and scarring in bladder is much diminished. He has no sensation to urinate, so he voids his bladder every three hours to keep it empty. His creatinine is at 1 and his cystatin is at 1.25. He swims and plays basketball, going through puberty, and growing tall (very thin though). Question: his urologist is insisting that he self-catheterize for at least six months to see if cystatin number will drop—and if not then he should self cath for life. My grandson is devastated and none of us understand how self cath will help his kidney when his bladder empties fully when he voids. Should we get second opinions from nephrologist. He has been through so much and so many surgeries, 2 last year to repair ureter and bladder. Help!?
I am a nephrologist and I would have no expertise in bladder management. Management of bladder issues is within the field of expertise for a urologist and not a nephrologist. You mention that the bladder is large and if this … Continue reading →
Can a right hydronephrosis with grade 4 be treated without surgery for 1 year old ? If yes , I would like to know how ? Is there any natural remedies ?
I am a nephrologist. I have no surgical experience or expertise. The question that you ask is a urological question and must be addressed to a urologist. A urologist is a surgeon who deals with surgical treatment of the kidney … Continue reading →
My 2 yr old son had 2 renal function tests with a 6 week interval in between tests. First test UREA was 5.2 (0.3-5.7) and his Creatinine 37 ( 13-34 ). The second test UREA 5.7 and creatinine 42. His pediatrician stated that she does not associate the results with kidney problem(s). The reason for the testing were due to numerous mild issues relating to sleep behavior, mild apnea, twitching sleep myoclonus and acid reflux. It is due to myself having horseshoe kidney. My father and another with pelvic kidneys. What do these test results tell you as a professional about my son’s kidney function? What other causes and the range readings be if its not kidney associated? Thank you.
I am an adult nephrologist and I have no experience with children and laboratory values. These mildly abnormal values should best be interpreted by a pediatrician who is used to looking at such values. I suggest that you express your … Continue reading →
Hi, I would like to ask, what is the right treatment of HSP? My five year old son got HSP and is being treated for last 3 months. He is taking lisinopril every day and prednisolone. He used to take twice a day 6ml of prednisolone and now for a month, he is taking every other day 8ml once. All what they do are blood test, when we go for follow up and urine test. Urine test is sometimes done just at their office and sometimes they want me to come back the next day with morning urine and take it to the lab. Last visit (Friday) showed blood results: sodium 135, potassium 3.8, CO2 23, blood urea 7, Albumin 3.7. And urine results (dipstick) : GLU Negative, BIL small, KET 15mg/dL, SG >=1.030, BLO large, pH 5.5, PRO 100mg/dL, URO 0.2, NIT negative, LEU negative. He used to have 300mg of protein in his urine. Friend of mine mentioned, that in my hometown, they do the clearance test, where I would have to be collecting the urine for 24 hours and they would see, if his kidneys are working properly or are damaged. Is he supposed to have done this test or from the blood test and urine test, which they do every visit (once a month now, before it was every two weeks), they can tell, if the kidneys are working properly? Thank you.
Henoch Schoenlein Purpura (HSP), sometimes called IgA Vasculitis, is a relatively common kidney disease in children. It generally resolves in several months. It generally does not require treatment. The blood and protein in the urine is very slow to resolve. … Continue reading →
Hello. My now, 5 year old son, when I was pregnant, he had fluid on his kidneys and was born with hydronephrosis. He had his checkups every 6 months up until we moved to another country in 2016. He was doing OK. No problems up until 2 months ago, he had been complaining of back pain, so I took him to get a sonogram to check fluid and he had little, not as much as he had before, and he had blood and urine tests done. The tests came back that he had a kidney infection. He was put on antibiotics. After he finished his medicine, the pain continued so I took him to a kidney specialist and all he did was tell me to go get him a US renal sonogram and get his urine and blood work. So I took him to get the sonogram. Doctor said he had no fluid on either kidney. The right kidney was 86x33x37mm and 10.6mm, his left was 82x33x39mm and 13mm. Doctor said no fluid on his kidneys, which was a relief but she said his spleen was swollen. She told me a child his age should be 105mm but my son was 116mm and she told me to wait for his blood and urine test results to come back to see if it’s from an infection or if not, then it’s normal. I am still waiting on his results but my question is what should I do next? Who should I take him to next? Should I worry with us being in another country? The health care is not anywhere close to the United States and that has me worried. Do I take the results and sonogram information back to the kidney specialist or should I see someone else? Any and all help and information would be very much appreciated. If you need more information or any questions, please contact me.
I am an adult nephrologist and I have no expertise with children. I would offer two recommendations. In most cases, I would have your son evaluated first by a pediatrician, rather than going directly to a kidney specialist. A pediatrician … Continue reading →
I have just found out today that my 14 year old son has a dilated renal pelvis and dilated ureter. The Mag-3 study suggests no VUR and it reads as if the kidney has cleared the isotope spontaneously but, says slow perfusion. The previous ultrasound only showed dilated distal ureter. Can you tell me how urgently I should expect to see a pediatric nephrologist? I am worried delay will cause more damage. His left kidney is already scarred and significantly impaired. I just don’t want to sit and wait weeks if its something requiring more urgent care. I hope you can provide some guidance.
The problem that you describe is a urological problem and must be addressed to a urologist. I am an adult nephrologist and I have no expertise in obstructive disease of the urinary tract and no expertise in the surgical management … Continue reading →
What is meant by left kidney small in size measuring 1.6* 1 cm with few small cyst (4 in no) of size 2-4 mm for a 4 month old baby? Is it dangerous?
I am an adult nephrologist and I do not have expertise regarding infants and children. You should discuss this result with your pediatrician or a pediatric Urologist.
Hello, doctor. I’m a mother with a 2 month old baby. I was diagnosed of IgA nephropathy since 2010. Will it still be okay to breastfeed my baby though I’m drinking prednisone and furosemide? I know it will affect my milk, and if so, will I ever breastfeed her again? Or once I stop my medications can my baby still drink my milk?
Prednisone should not pose any risk to your infant as long as you are not on high doses of prednisone. Furosemide is more of a problem. I suggest that you visit with your pediatrician about this and determine what is … Continue reading →
Dr., A boy who is 12 years old has kidney issues. One kidney is removed about 2.5 years ago. Now the 2nd kidney has some blockage. The Doctor suggests that if we operate on blockage then he needs dialysis for a lifetime. We are in trouble. Can you suggest? Please, Dr. help us.
Blockage of the kidney is a urological problem and usually evaluated by a Urologist. I am a nephrologist and I have no surgical expertise. You should consult with a urologist about options that might be available for this young boy. … Continue reading →
My 3 year old daughter was diagnosed with extrarenal pelvis. She was seen in the ER in October for a severe UTI, since then she got UTI three more times! She had an ultrasound last week & that was how they discovered it. Her pediatrician said this isn’t a problem & won’t cause her to have more UTI’s? Should I take her to see a specialist? And will this affect her later on in life?
I am an adult nephrologist and do not see children. In this case, I suggest that your daughter see a pediatric urologist. It is true that an extra-renal pelvis does not typically cause any problems, however, if she is young … Continue reading →