Presentation of the Child with Renal Disease and Guidelines for Referral to the Pediatric Nephrologist
Table 1
Role of the pediatrician in the management of the child with renal disease [1].
(1) keep a high index of suspicion for UTI and renal disease
(2) take patient/family history, perform a complete physical exam with BP, and exclude the presence of systemic diseases
(3) perform a urinalysis on patient, and, when indicated, on family members, urine culture, antibiogram, and other laboratory tests: BUN, creatinine, electrolytes, serum complement, quantitative proteinuria, and creatinine clearance
(4) order imaging studies: renal ultrasound, VCUG, renal scan and others on patients with UTI, and suspected congenital abnormalities and calculi
(5) screen for orthostatic proteinuria and tubular disorders
(6) treat UTI, uncomplicated acute GN, conditions not associated with acute or progressive deterioration of renal function: minimal change nephrotic syndrome, mild abnormalities and others that the physician is comfortable with
(7) follow-up patients that the physician is comfortable with
(8) discuss and refer children with renal and urinary tract abnormalities diagnosed on routine prenatal ultrasound
