Presentation of the Child with Renal Disease and Guidelines for Referral to the Pediatric Nephrologist

Table 2

Guidelines for patient referral to the pediatric nephrologist [1].

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(1) persistent unexplained hematuria, nonorthostatic proteinuria and HT

(2) decreased renal function (acute, chronic, and ESRD)

(3) renal tubular disease

(4) nephrotic syndrome, particularly steroid-dependent or -resistant

(5) atypical or persistent GN

(6) unexplained and severe acid-base and electrolyte abnormalities

(7) systemic diseases associated with progressive renal involvement-systemic SLE and diabetes mellitus

(8) genetic and congenital abnormalities likely to produce progressive renal damage

(9) when invasive studies, for example, kidney biopsy, are indicated

(10) major renal/urinary tract abnormalities found on routine prenatal ultrasound

(11) renal disease that is likely to progress—FSGN and IgA nephropathy

(12) conditions associated with acute complications—HT, calculi, and HUS

(13) when teamwork is needed—urologist, geneticist, dietician, and social worker

(14) parental anxiety

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HT: hypertension; ESRD: end-stage renal disease; GN: glomerulonephritis; SLE: systemic lupus erythematosis, FGS: focal glomerulosclerosis; HUS: hemolytic uremic syndrome.