Dr Swati Bhardwaj, Pediatric Nephrologist – Pediatric Practice… Pearls for your Pediatric Office Practice

Hypertension…

When should one measure a blood pressure in children?

6 Dec 20206 Dec 2020

Blood pressure (BP) should be measured annually in children and adolescents 3 years onwards. BP should be checked in all children and adolescents 3 years onwards at every health encounter…

Evaluation of Renal Disease…

Can hematuria result in anemia or proteinuria

19 Nov 202018 Nov 2020

Usually even gross hematuria doesn’t result in significant blood loss, except in case of trauma. 1 ml of blood in 1000 ml urine is sufficient to cause red discoloration of…

Evaluation of Renal Disease…

Evaluating a child with “RED URINE”

15 Nov 202015 Nov 2020

All cases of red urine are not due to hematuria. Ask - History of fever, dysuria, rash, joint pain etc. If asymptomatic ask history of ingestion of beet-root, food colouring…

Evaluation of Renal Disease…

Urine calcium creatinine ratio & Hypercalciuria

22 Oct 202021 Oct 2020

Calcium creatinine ratio on spot urine sample is a good screening test for hypercalciuria. A ratio of >0.8 mg/mg in children below 6 months , >0.6 mg/mg in children 6-12…

Screening tests for diagnosing urinary tract infection (UTI)

30 Jul 202029 Jul 2020

Screening tests include urine microscopy, gram stain, leukocyte esterase and nitrite tests. Urine microscopy: Pyuria is defined as >10 WBCs/mm3 in uncentrifuged and >5 WBCs/hpf in centrifuged urine specimen. Pyuria may be…

Evaluation of Renal Disease…

Polakiuria

26 Jul 202025 Jul 2020

Voiding disorders are common but under recognised in children. Increased daytime urinary frequency is one such condition which troubles the patient and caregivers alike. Frequent urination can have causes that…

Management of relapses of nephrotic syndrome

29 Mar 202017 Mar 2020

Recurrence of proteinuria more than 3+/4+ by dipstick testing, for 3 consecutive days with swelling constitutes a relapse. Prednisolone is given @ 2 mg/kg/day till urine protein is negative/trace for…

Diagnosis & Management of First Episode of nephrotic syndrome

26 Mar 202017 Mar 2020

Nephrotic syndrome is diagnosed in a child with Edema: usually starts as periorbital puffiness with variable degree of generalized body swelling.Heavy proteinuria: defined as urine dipstick protein 3+/4+ or spot…

Urinary Tract Infections…

Imaging studies after first episode of urinary tract infection (UTI)

12 Mar 20209 Mar 2020

Ultrasound kidneys is recommended in all cases with UTI irrespective of age. Dimercaptosuccinic acid scan (DMSA) should only be done after 3 to 4 months of treatment to detect renal…

Obstructions of the Urinary Tract…

Antenatal Hydronephrosis

12 Jan 20209 Jan 2020

Antenatal hydronephrosis is classified according to severity based on antero-posterior diameter (APD) of fetal renal pelvis in USG. Antenatal hydronephrosis is present if the APD is ≥4 mm in second…