1. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Alterations of Renal and Urinary Tract Function in Children Chapter 30

2. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structural Abnormalities  Horseshoe kidney  Hypospadias  Chordee  Epispadias  Exstrophy of the bladder

3. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Hypospadias

4. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Structural Abnormalities  Bladder outlet obstruction  Ureteropelvic junction obstruction (UPJ)  Secondary UPJ  Hypoplastic or dysplastic kidneys  Renal aplasia or dysplasia  Polycystic kidney disease  Renal agenesis  Unilateral or bilateral (Potter syndrome)

5. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Glomerular Disorders  Glomerulonephritis  Immunoglobulin A (IgA) nephropathy  Nephrotic syndrome  Hemolytic uremic syndrome

6. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Glomerulonephritis  Acute poststreptococcal glomerulonephritis  Occurs after a throat or skin infection with certain strains of group A alpha-hemolytic streptococci  Experience a sudden onset of hematuria, edema, hypertension, and renal insufficiency

7. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Glomerulonephritis  Acute poststreptococcal glomerulonephritis  Antigen-antibody complexes and complement are deposited in the glomerulus  The immune complexes initiate inflammation and glomerular injury

8. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Glomerulonephritis  Immunoglobulin A (IgA) nephropathy  IgA nephropathy is characterized by the deposition of mostly IgA but some IgM antibodies and complement in the mesangium of the glomerular capillaries

9. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Glomerulonephritis  Henoch-Schönlein purpura nephritis  Also referred to as anaphylactoid purpura  IgA nephropathy that causes inflammation and damage to the glomerular blood vessels

10. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Nephrotic Syndrome  Nephrotic syndrome is a symptom complex related to loss of protein in the urine  Minimal change nephropathy (MCN)  Focal segmental glomerulosclerosis (FSGS)  Congenital nephrotic syndrome  Nephrotic syndrome can be primary or secondary in relation to cause

11. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Hemolytic-Uremic Syndrome (HUS)  HUS is the most common cause of acute renal failure in children  There is an association of HUS with bacterial and viral agents  Escherichia coli 0157:H7

12. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Hemolytic-Uremic Syndrome (HUS)  The bacterial toxin from E. coli damages red cells and endothelial cells  The endothelial lining of the glomerulus becomes swollen and occluded with fibrin clots

13. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Hemolytic-Uremic Syndrome (HUS)  The damaged red cells are removed from the circulation by the spleen, causing acute hemolytic anemia  The microcirculation develops numerous thrombi

14. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Urinary Tract Infections (UTIs)  UTIs are common 7- to 11-year-old girls  E. coli, the most common pathogen, ascends the urethra in cystitis or the ureter in pyelonephritis  Cystitis  Acute and chronic pyelonephritis

15. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Vesicoureteral Reflux (VUR)  Retrograde flow of urine from the bladder into the ureters  Reflux encourages infected urine from the bladder to be swept up into the kidneys  Leads to frequent pyelonephritis

16. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Vesicoureteral Reflux (VUR)  Caused by a congenital abnormality or ectopic insertion of the ureter into the bladder  Diagnosed by a voiding cystourethrogram (VCUG) and an intravenous pyelogram (IVP)

17. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Vesicoureteral Reflux (VUR)

18. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Wilms Tumor  Wilms tumor is an embryonal tumor of the kidney  Wilms tumor arises from the proliferation of abnormal renal stem cells  Inherited and sporadic forms  Usually found by parent due to abdominal swelling

19. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Enuresis  Involuntary passage of urine by a child who is beyond the age (4 to 5 years old) when voluntary bladder control should have been acquired  Primary enuresis  The child has never been continent  Secondary enuresis  Diurnal, nocturnal, or both

20. Elsevier items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Some material was previously published. Enuresis  Theories  Organic causes  Maturational lag  Genetic factors  Sleep patterns  Psychosocial theories