Category Archives: Pediatric Issues

My son, who is 4, has been told that his right kidney had shrunk since last Friday. What could be the cause of that?

I do not believe that a kidney can shrink in a very short time. I am an adult nephrologist and do not see children. In most cases, I would guess that a small kidney in a 4 year old would … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Pediatric Issues

Hello Dr. Spry, my 5 yo daughter has mild hydronephrosis (right kidney) and vomiting episodes where she quickly becomes acidotic. Her urologist ordered a Mag3 test to be completed soon to find out more. The urologist as well as the hematologist weren’t sure if the hydronephrosis could be contributing to my daughter’s unexplained ongoing normochromic/normocytic anemia, so I wanted to reach out to get your thoughts to see if the two could be possibly connected. Her erythropoietin level was at 8 which was lower than expected for a hemoglobin of 9. Thanks.

I do not know of any association between blockage of the kidney (hydronephrosis) and anemia. If the kidney damage was present in both kidneys and there was associated kidney failure, then anemia related to kidney failure could be present. The … Continue reading

Posted in Anemia, Ask the Doctor, Chronic Kidney Disease, Hydronephrosis and Hydroureter, Kidney Failure, Kidney-Related Health Questions, Pediatric Issues

Dear Dr, my 6 year old daughter has constant nose bleeds and swelling near the ankles. I took her to the Pediatrician and he sent for some lab work. Her BUN/CREAT ratio is 60. Is this high level common? He cannot see her until a few days. Thanks.

The Blood Urea Nitrogen to creatinine ratio (BUN/CREAT ratio) is not commonly used to estimate kidney function. An elevated ratio can suggest dehydration. An elevated BUN/CREAT ratio can also suggest that there is bleeding that is occurring and getting into … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Pediatric Issues

Dear Sir, My 3 year old son suffered from hydronephrosis. Date of Birth 25 Jan 2015. KIdney [RT 49*25mm LT 62*29mm]. He has suffered in a month 2-3 times.

I am an adult nephrologist and do not see children. I suggest that you consult with a pediatric urologist. A urologist deals with hydronephrosis in children.

Posted in Ask the Doctor, Kidney-Related Health Questions, Pediatric Issues, Urological Issues

My 7-year-old daughter had bloodwork done to try to understand why she has constant stomachaches. A CBC was done and her BUN level came back slightly elevated at 19 (ref. range 5-18 mg/dL) but her BUN/creatinine level is significantly elevated (in my opinion) at 63 (ref. range 13-32). All other parameters tested are within normal ranges. Should I be concerned and what further steps would you recommend?

The Blood Urea Nitrogen (BUN) test could be elevated because of dehydration in someone who has a stomach ache.  I do not have much confidence in the BUN to creatinine ratio.  I do not find it a helpful test.  I … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Pediatric Issues, Symptoms and Side Effects

My daughter is 7. While I was pregnant with her I was told that she had hydronephrosis in both kidneys. I was closely monitored for the remainder of my pregnancy until they decided to induce labor early because her kidneys were becoming to swollen. When she was born she was immediately taken for an ultrasound testing. They said her kidneys were normal and functioning at 100%. Her pediatrician told me that the hydronephrosis had taken care of itself. 5 years later she had severe pain one day and I rushed her to the ER where I learned that my daughter now only has one kidney. Which was severely infected I also learned that she has severe hydronephrosis in her remaining solitary left kidney. She has had numerous UTI since that day. Also, 2 seperate episodes where she could not urinate for some 12+ hours. With the last episode being the worst in July. She has been tested for stones and they cannot find anything. The doctor just yesterday told me he didn’t believe based on all of her tests that she’s ever had a stone. But he also had no further insight as to what could be going on. I don’t understand why she’s had hydronephrosis or how it came back after being cleared as an infant. We have been seeing a urologist for 2 years now and still do not have much to go on for answers. So I guess I’m asking you if you have any advice or opinions in what direction we should be looking? Is there a way to fix this or is it just sit and wait until her kidney can’t withstand much more, start dialysis and go on the transplant

I am an adult nephrologist and do not see children.  The problem that you describe is a urological problem and I have no expertise in this area.  Your daughter may need to see a pediatric urologist, if she has not … Continue reading

Posted in Ask the Doctor, Birth Defects/Urinary Tract Abnormalities, Hydronephrosis and Hydroureter, Kidney-Related Health Questions, Nephrectomy / One kidney, Pediatric Issues, Pregnancy / Kids, Symptoms and Side Effects, Treatments, Urological Issues

I found out my son had hydronephrosis when I was 20 weeks pregnant. He is currently 2 years old and on the lower side of the growth chart. My husband wants to start him on a dietary supplement so that hopefully he will gain more weight (he is currently 23 lbs.). Is there any research to support a connection to his low growth and the hydronephrosis? Should we just continue to let him grow and develop on his own and not put him on a dietary supplement? He has the eating habits of a 2 year old, he is picky and sometimes he does not eat at all. Any advice or reading material you can provide would be greatly appreciated.

I am an adult nephrologist and I have no experience with children and congenital hydronephrosis. I suggest that you consult with your pediatrician about your concerns.

Posted in Ask the Doctor, Hydronephrosis and Hydroureter, Kidney-Related Health Questions, Pediatric Issues

My child is 2 years old. He is suffering from FSGS and steroid resistance. Now his creatinine level is 6 and no treatment is working to control the disease. Kindly guide me in this regard.

The treatment of focal and segmental glomerulosclerosis (FSGS) is very difficult and sometimes is unsuccessful. I am an adult nephrologist and do not have expertise in pediatric nephrologist. I suggest that you consult with a pediatric nephrologist regarding your child.

Posted in Ask the Doctor, FSGS, Kidney-Related Health Questions, Pediatric Issues

Hi, My 4 year son has MCKD on the left side with no function at all. On the right side, he has megaurethra. He took antibiotics to prevent infections from birth til he turned 2 year old. At the same time he developed high blood pressure. He has been on Enalapril 1,5mg since he turned 2 and had to increase the dose to 2mg right after he turned 4. With this dosage, his blood pressure is 111/44 (70). His last blood test was like this; Hb 12,6. Leuk 6,3. Trc 413. Na137. K 4,2. Ion Ca 1,16. Fosfat 1,49. Osm 296. Krea 33. Cys C 0,83. Urea 7,2. Alat 47. Alb 37. Normal ascidbase. His urine test was like this; Krea 6,22. Alb/krea ratio 1, totalprotein/krea ratio 17, alb 7. Stick neg. Can you tell me what his urine and blood test means combined with the high blood pressure?

I am an adult nephrologist and do not see children. The laboratory information that you provide is difficult to interpret without knowing the units of measurement and the normals for the laboratory that you used.  These laboratory results are best … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrologist, Pediatric Issues

My 2 Year old Nephew has some problem in his left kidney. Please suggest on what kind of medication or operation can help for this. Mentioning the result of the latest diagnosis done: Left Kidney: appears bulky. It shows normal in size, shape and outline. It shows slightly faint contrast opacification and s/o persistent dense nephrogram in delayed image. Pelvicalyceal system is overfilled with clubbing of calyces. Left renal pelvis is dilated. Left Ureter is not well seen even on delayed scans. Delayed films after lasix IV injection shows washout of contrast post lasix 15 minutes image. IMPRESSION: Hydronephrosis Left Kidney with Dilated Pelvis With Persistent Dense Nephrogram with Washout of Contrast After Lasix S/O PUJ Obstruction(Partial) Normal Right Kidney and Urinary Bladder.

The problem that you describe is a urological problem. This should be evaluated by a urologist and preferably a pediatric urologist. I am a nephrologist and have no expertise in the evaluation and treatment of ureteropelvic junction obstruction (UPJ obstruction). … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Pediatric Issues, Urological Issues