Pediatric Nephrology for Primary Care Amin J. Barakat and Russell W. Chesney Editors American Academy of Pediatrics 141 Northwest Point Blvd Elk Grove Village, IL 60007-1098 AAP Department of Marketing and Publications Maureen DeRosa, MPA, Director, Department of Marketing and Publications Mark Grimes, Director, Division of Product Development Diane Lundquist, Senior Product Development Editor Sandi King, MS, Director, Division of Publishing and Production Services Kate Larson, Manager, Editorial Services Theresa Wiener, Manager, Editorial Production Peg Mulcahy, Graphic Designer Jill Ferguson, Director, Division of Marketing Linda Smessaert, Manager, Clinical and Professional Publications Marketing Robert Herling, Director, Division of Sales Library of Congress Control Number: 2008941470 ISBN: 978-1-58110-297-0 MA0441 The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. Copyright © 2009 American Academy of Pediatrics. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photo copying, recording, or otherwise, without prior written permission from the publisher. Printed in the United States of America. 9-200/1108 Last digit is the print number: 9 8 7 6 5 4 3 2 1 iii Contributors Alfred Z. Abuhamad, MD Professor and Chairman, Department of Obstetrics and Gynecology, Eastern Virginia School of Medicine, Norfolk, VA Uri S. Alon, MD Professor of Pediatrics, Director of Bone and Mineral Disorders Clinic, Section of Pediatric Nephrology, Children’s Mercy Hospital and Clinics, University of Missouri Kansas City School of Medicine, Kansas City, MO Sharon P. Andreoli, MD Byron P. and Frances D. Hollett Professor of Pediatrics, Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis, IN Billy S. Arant, Jr, MD, FAAP Professor, Department of Pediatrics, University of Tennessee College of Medicine, Chattanooga, TN Bettina H. Ault, MD Associate Professor, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN Amin J. Barakat, MD, FAAP Clinical Professor, Department of Pediatrics, Georgetown University School of Medicine, Washington, DC Eliza M. F. Berkley, MD Assistant Professor, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA Eileen D. Brewer, MD, FAAP Professor and Head, Pediatric Renal Section, Baylor College of Medicine, and Chief, Renal Service at Texas Children’s Hospital, Houston, TX Douglas A. Canning, MD Chief, Division of Urology, University of Pennsylvania School of Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA iv Pediatric Nephrology for Primary Care Andy Yu-How Chang, MD Assistant Professor, Division of Pediatric Urology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA Russell W. Chesney, MD, FAAP Le Bonheur Professor and Chair, Department of Pediatrics, The University of Tennessee Health Science Center, Memphis, TN Noel M. Delos Santos, MD Assistant Professor of Pediatrics and Pediatric Nephrology, University of Tennessee Health Science Center, Memphis, TN Agnes B. Fogo, MD Professor of Pathology, Medicine and Pediatrics, and Director of the Renal/ Electron Microscopy Laboratory, Vanderbilt University Medical Center, Nashville, TN John Foreman, MD, FAAP Professor and Chief, Division of Pediatric Nephrology, Duke University Medical Center, Durham, NC Aaron Friedman, MD, FAAP Professor and Chairman, Department of Pediatrics, Brown Medical School, Hasbro Children’s Hospital, Providence, RI Uttam Garg, PhD Professor of Pathology, Director of Clinical Chemistry and Toxicology, Department of Pathology and Laboratory Medicine, Children’s Mercy Hospital and Clinics, University of Missouri Kansas City School of Medicine, Kansas City, MO M. Colleen Hastings, MD Assistant Professor, Departments of Pediatrics and Internal Medicine, University of Tennessee Health Sciences Center, Children’s Foundation Research Center at Le Bonheur Children’s Medical Center, Memphis, TN Iekuni Ichikawa, MD Professor of Pediatrics and Medicine, Vanderbilt University School of Medicine, Nashville, TN, and Professor of Bioethics, Tokai University School of Medicine, Isehara, Japan Contributors v Deborah P. Jones, MD Professor of Pediatrics, University of Tennessee Health Science Center, Children’s Foundation Research Center at Le Bonheur Children’s Medical Center, Memphis, TN Fumio Niimura, MD Associate Professor of Pediatrics, Tokai University School of Medicine, Isehara, Japan H. Norman Noe, MD, FAAP, FACS Professor of Urology and Chief, Division of Pediatric Urology, University of Tennessee, Memphis College of Medicine, Le Bonheur Children’s Medical Center, Memphis, TN Victoria F. Norwood, MD Professor of Pediatrics and Chief, Pediatric Nephrology, University of Virginia Children’s Hospital, Charlottesville, VA H. Gil Rushton, MD, FAAP Professor of Urology and Pediatrics, The George Washington Univer- sity School of Medicine, and Chief, Division of Pediatric Urology, Children’s National Medical Center, Washington, DC Nina Salhab, MS, RD/LD Pediatric Renal Dietician, Department of Pediatrics, University of Texas Southwestern Medical School at Dallas, Children’s Medical Center of Dallas, Dallas, TX S. Sedberry-Ross, MD Chief Resident, Department of Urology, George Washington University School of Medicine, Washington, DC Mouin G. Seikaly, MD, FAAP Professor of Pediatrics, University of Texas Southwestern Medical School at Dallas, and Chief of Solid Organ Transplant Program, Children’s Medical Center of Dallas, Dallas, TX Tarak Srivastava, MD Assistant Professor of Pediatrics, Section of Pediatric Nephrology, Children’s Mercy Hospital and Clinics, University of Missouri Kansas City School of Medicine, Kansas City, MO vi Pediatric Nephrology for Primary Care Mark A. Williams, MD, FAAP, FACS Assistant Professor, Department of Urology, University of Tennessee College of Medicine, Le Bonheur Children’s Medical Center, Memphis, TN Robert J. Wyatt, MD Chief, Division of Pediatric Nephrology, University of Tennessee Health Science Center, Children’s Foundation Research Center at Le Bonheur Children’s Medical Center, Memphis, TN Aida Yared, MD, FAAP Assistant Professor of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN To our children, our grandchildren, and the children of the world, who inspire us to work harder for a better life for all. ix Contents Foreword .............................................................................................................................. xi Preface ................................................................................................................................ xiii Chapter 1. Presentation of Patients With Renal Disease and Guidelines for Patient Referral: Amin J. Barakat .......................................................... 1 Chapter 2. History and Physical Examination of the Child With Renal Disease: Aida Yared and Amin J. Barakat................................................ 13 Chapter 3. Examination of the Urine: Agnes B. Fogo and Amin J. Barakat ........... 33 Chapter 4. The Role of the Clinical Laboratory in the Diagnosis of Renal Disease: Tarak Srivastava, Uttam Garg, and Uri S. Alon ....................... 57 Chapter 5. Imaging of the Kidney and Urinary Tract: S. Sedberry-Ross and H. Gil Rushton............................................................................................. 77 Chapter 6. Urinary Tract Infection: Billy S. Arant, Jr .............................................. 119 Chapter 7. Hematuria: Noel M. Delos Santos and Bettina H. Ault ........................ 143 Chapter 8. Proteinuria: Victoria F. Norwood ........................................................... 159 Chapter 9. Glomerular Disease: M. Colleen Hastings and Robert J. Wyatt .......... 173 Chapter 10. Renal Tubular Disease: Russell W. Chesney .......................................... 193 Chapter 11. Water and Electrolyte Disorders: Aaron Friedman .............................. 213 Chapter 12. Acid-Base Disturbances: Fumio Niimura and Iekuni Ichikawa .......... 229 Chapter 13. Acute Kidney Injury: Sharon P. Andreoli .............................................. 247 Chapter 14. Chronic Kidney Disease: Mouin G. Seikaly and Nina Salhab ............ 267 Chapter 15. Hypertension: Deborah P. Jones .............................................................. 287 Chapter 16. Genetic Diseases of the Kidney: John Foreman .................................... 313 Chapter 17. Prenatal Diagnosis of Renal and Urinary Tract Abnormalities: Eliza M. F. Berkley and Alfred Z. Abuhamad ........................................ 333 Chapter 18. Pediatric Urology and Congenital Anomalies of the Kidney and Urinary Tract: Andy Y. Chang and Douglas A. Canning ..................... 351 Chapter 19. Renal Calculi: Mark A. Williams and H. Norman Noe ........................ 381 Chapter 20. The Kidney in Systemic Disease: Eileen D. Brewer .............................. 397 Chapter 21. Prevention of Kidney Disease: Amin J. Barakat ................................... 419 Appendices ....................................................................................................................... 433 Appendix