{"title":"Acute renal failure.","authors":"Ivy I Boydstun","doi":"10.1016/j.admecli.2004.09.002","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.002","url":null,"abstract":"<p><p>Acute renal failure (ARF) can be defined as the sudden loss of adequate renal function to clear metabolic wastes and maintain normal fluid and electrolyte balance. ARF may occur in otherwise healthy children, may complicate underlying chronic kidney disease, or may result from multiorgan disorders. The underlying cause of the renal injury remains the major factor that determines outcomes for patients with ARF. Overall mortality in children with ARF varies from 8% to 89%, with greater than 50% mortality associated with three-organ system failure. Management of the adolescent with ARF ranges from conservative management in mild cases to more intensive care in hospitalized patients with complications of fluid overload, hypertension, metabolic acidosis, or life-threatening hyperkalemia.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"1-9, ix"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hematuria in adolescents.","authors":"Carrie Gordon, F Bruder Stapleton","doi":"10.1016/j.admecli.2004.09.005","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.005","url":null,"abstract":"<p><p>Hematuria is not a rare finding during adolescence. The high prevalence of microscopic hematuria is not surprising when one considers the vast number of ways in which RBC can end up in the urine. The adolescent presenting with gross hematuria, proteinuria, or microscopic hematuria in combination with other symptoms of genitourinary disease is more likely to require a therapeutic intervention than is the individual found incidentally to have microscopic hematuria. Screening for hematuria is not supported by current evidence. When it is discovered as the result of a screening examination, persistent microscopic hematuria in an otherwise asymptomatic individual may not require further investigation; however, the renal ultrasound examination has little risk and is helpful in diagnosing many of the conditions amenable to intervention. Serum studies offer little useful information in the evaluation of microscopic hematuria. Addressing isolated hematuria in a systematic, evidence-based fashion can help avoid untoward patient and parental worry and excessive health care costs, without missing treatable or progressive disease entities.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"229-39"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chronic kidney disease in adolescents.","authors":"Ivy I Boydstun","doi":"10.1016/j.admecli.2004.09.001","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.001","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) involves a fixed deficit or progressive deterioration in kidney function, producing variable losses of normal physiologic functions. In adolescents, CKD results from a wide range of causes. Because of the broad spectrum of disease, the physician providing primary care to the adolescent must be knowledgeable about findings leading to the diagnosis of CKD and must understand the physiologic basis for therapeutic management. Complications of normal renal function loss include issues of fluid, electrolyte, and acid-base balance, as well as development of anemia, cardiovascular disease, metabolic bone disease, and growth failure. Goals of therapy include anticipation and replacement of lost physiologic functions so that the adolescent can grow and develop normally.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"185-99, xii"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcos R Perez-Brayfield, Adam Baseman, Andrew J Kirsch
{"title":"Adolescent urology.","authors":"Marcos R Perez-Brayfield, Adam Baseman, Andrew J Kirsch","doi":"10.1016/j.admecli.2004.09.004","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.004","url":null,"abstract":"<p><p>The area of adolescent urology encompasses a period of development that coincides with puberty. Disorders seen during this time either carry over from childhood (eg, hydronephrosis, enuresis, voiding dysfunction) or are early manifestations of urologic problems seen more commonly in adulthood (eg, urolithiasis, varicoceles). This article focuses on several areas of urology common to the adolescent.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"215-27, xiii"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urolithiasis in adolescent children.","authors":"Tarak Srivastava, Uri S Alon","doi":"10.1016/j.admecli.2004.10.003","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.10.003","url":null,"abstract":"<p><p>Idiopathic urolithiasis in children has become more frequent in the past few decades as a result of increasing affluence and rapid change in our society's dietary habits. In Western societies, calcium stones in the kidney and ureter predominate. Pediatric urolithiases, unlike the adult form, require a comprehensive metabolic evaluation, because metabolic and enzymatic derangements play an important role in their pathogenesis. The recent advancements in endoscopic procedures, interventional radiology, and lithotripsy have allowed children to be managed effectively without open surgery. Pediatric urolithiasis requires a close working relationship between the urologist for acute surgical management of urolithiasis and the nephrologists for prevention of stone formation. In many children and adolescents with urolithiasis, a nonpharmacologic approach involving the adoption of healthy nutrition habits may suffice.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"87-109"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nephrologic Disorders in the Adolescent","authors":"Jules Sherwinter, D. Foulds, D. Greydanus","doi":"10.1016/J.ADMECLI.2004.11.001","DOIUrl":"https://doi.org/10.1016/J.ADMECLI.2004.11.001","url":null,"abstract":"","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/J.ADMECLI.2004.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"53968634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dilip R Patel, Alfonso D Torres, Donald E Greydanus
{"title":"Kidneys and sports.","authors":"Dilip R Patel, Alfonso D Torres, Donald E Greydanus","doi":"10.1016/j.admecli.2004.09.007","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.007","url":null,"abstract":"<p><p>With better understanding of the nature of renal disease and its treatment, many more adolescents are now allowed to participate in recreational and competitive sports. The positive physiologic and psychological effects of exercise are increasingly being appreciated in adolescents with chronic diseases. This article reviews relevant aspects of renal disease that have implications for sports participation by adolescents, including hematuria, proteinuria, hyponatremia, hypertension, solitary kidney, exercise-related acute renal failure, and chronic/end-stage renal disease. It also reviews the renal effects of creatine and protein supplementation in athletes.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"111-9, xi"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Renal transplantation in adolescents.","authors":"Jodi M Smith, Ruth A McDonald","doi":"10.1016/j.admecli.2004.09.003","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.003","url":null,"abstract":"<p><p>Renal transplantation remains the goal for the pediatric patient with end-stage renal disease. Recent advances in technology and immunosuppression have greatly enhanced patient and graft survival, while reducing significant complications. However, transplantation of adolescents is still fraught with the potential for serious problems. The increased risk of graft loss, late acute rejection, and incomplete rejection reversal observed in the adolescent age group demands further investigation. Lack of adherence to immunosuppression regimens may be an important contributory factor. Strategies to address the unique concerns of this high-risk population, including the use of a multidisciplinary team, are essential to improving outcomes.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"201-14"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Glomerulonephritis.","authors":"Keith K Lau, Robert J Wyatt","doi":"10.1016/j.admecli.2004.09.008","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.008","url":null,"abstract":"<p><p>GN in the adolescent requires prompt diagnosis. When even mild degrees of renal insufficiency are documented, immediate referral to a nephrologist is necessary to ensure that serious conditions, such as RPGN, are correctly diagnosed and aggressively managed. In an adolescent with macroscopic hematuria, the demonstration of dysmorphic RBCs, RBC casts, and proteinuria indicates that the bleeding is of glomerular origin. Physicians caring for adolescents with chronic GN should have a basic understanding of the specific disorders. They may be involved in blood pressure monitoring and should be aware of the potential side effects of the antihypertensive and immunosuppressive medications used in patients with GN.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"67-85"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adolescents with proteinuria and/or the nephrotic syndrome.","authors":"Ronald J Hogg","doi":"10.1016/j.admecli.2004.09.009","DOIUrl":"https://doi.org/10.1016/j.admecli.2004.09.009","url":null,"abstract":"<p><p>Persistent proteinuria of various degrees of severity in adolescents should be regarded seriously, because recent evidence points to this abnormality's being associated with chronic kidney disease. However, it is also important for primary care physicians to be aware that most adolescents who are found to have proteinuria on a screening urinalysis do not have renal disease, and the proteinuria will usually resolve on repeat testing. Appropriate measures to determine whether the proteinuria is fixed and not orthostatic can and should be conducted expeditiously, because they will allay stress for most patients. For the minority of patients in whom more serious forms of proteinuria exist, timely consultation with a pediatric nephrologist is recommended.</p>","PeriodicalId":87044,"journal":{"name":"Adolescent medicine clinics","volume":"16 1","pages":"163-72"},"PeriodicalIF":0.0,"publicationDate":"2005-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.admecli.2004.09.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25069613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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