Chapter 17: Renal Disorders in Children

Renal Disorders in Children begins by outlining the anatomy and physiology of the pediatric renal system, noting significant developmental differences such as the immaturity of renal function in children under two years of age and the proximity of the kidneys to the umbilicus. The text details essential nursing assessments, including the evaluation of hydration status, blood pressure monitoring, and the interpretation of urinalysis and serum electrolyte values. A major portion of the chapter is dedicated to common infectious and structural disorders, specifically urinary tract infections (UTIs) and vesicoureteral reflux (VUR), outlining diagnostic procedures like the voiding cystourethrogram (VCUG) and the importance of preventing renal scarring. The chapter provides in-depth coverage of glomerular and vascular disorders, including Nephrotic Syndrome, characterized by massive proteinuria and edema; Acute Postinfectious Glomerulonephritis (APIGN), often following streptococcal infections; Henoch-Schönlein Purpura (HSP), a vasculitis presenting with purpura and renal involvement; and Hemolytic Uremic Syndrome (HUS), a triad of anemia, thrombocytopenia, and acute kidney injury often linked to E. coli infections. Furthermore, the text distinguishes between Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD), detailing the pathophysiology, staging, and complex management strategies required for each, such as dietary modifications, fluid restrictions, antihypertensive therapy, and renal replacement therapies like hemodialysis and peritoneal dialysis. Finally, the chapter addresses congenital genitourinary anomalies, including cryptorchidism and hypospadias, focusing on surgical interventions and postoperative care to preserve fertility and function.