Common paediatric renal conditions

Abstract

Chronic kidney disease (CKD) is not a priority on the health agenda in South Africa and this is particularly true with regard to children. Infectious diseases like HIV and tuberculosis, respiratory diseases, malnutrition and trauma enjoy a far more prominent status as an attention-worthy cause of morbidity and mortality. Unfortunately several congenital and acquired kidney diseases in children are associated with non specific symptoms and signs, which often result in delayed diagnosis. Late referral is associated with increased mortality and morbidity and deprives the patient of treatment to prevent of delay chronic kidney disease progression. It is imperative, therefore, that all health care professionals should be vigilant to identify children with underlying kidney disease and institute preventive treatment to slow progression of disease towards end-stage renal failure.
The aim of this article is to highlight the features of the common congenital abnormalities of the kidney and urinary tract (CAKUT) clinicians are likely to come across in clinical practice. The conditions which will be discussed include multicystic dysplastic kidney (MCDK), vesico-ureteric reflux (VUR) and obstructive uropathy due to posterior urethral valves (PUV) or pelvo-ureteric junction obstruction (PUJO).