Grand Rounds in Pediatric Nephrology
Recorded On: 05/03/2021
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- A tale of two pathologies: Rapidly Progressive Glomerulonephritis and Acute Tubulointerstitial Nephritis
- Nephropathic Cystinosis: How to Diagnose and Treat
- Make the Peritoneal Membrane Work for You
- Approach to Infantile Hypercalcemia
- Pediatric Renal Genetics: New Advances
- Management of Renal Bone Disease
- Resistant Hypertension in Children on Dialysis
- C3 Glomerulonephritis and Dense Deposit Disease – A Tale of Two Twins
- Immunosuppression vs post-transplant viral infections: Walking a fine line
- A Challenging Case of Nephrotic Syndrome
- The Spectrum of Alport Syndrome: Who and how to investigate?
Rukshana Shroff
UK
Neha Bhongale
India
Jyoti Sharma
India
John Mahan
USA
Sukanya Govindan
India
Oluseyi Oniyangi
Nigeria
Gabriel Obiorah Ezeh
Nigeria
Shaegan Irusen
South Africa
Priya Pais
India
Soumya Reddy
India
Paul Goodyer
Canada
Elena Levtchenko
Belgium
Larisa Prikhodina
Russia
Svetlana Papizh
Russia
Felicia Eke
Nigeria
Ifeoma Anochie
Nigeria
Frederick Kaskel
USA
James Pullman
USA
Kimberly Reidy
USA
Nicole Hayde
USA
Pooja G N
India
Marcelo Orias
USA
Indira Agarwal
India
Rouba Garro
USA
Naorem Lakshmee Devi
India
Sukanya Govindan (Moderator)
India
Nadira Sultana
Bangladesh
Ng Kar Hui
Singapore
Syed Saimul Huque
Bangladesh
Fiona Mackie (Moderator)
Australia
Rajiv Sinha
India
Sanjukta Poddar
India
Mordi Mourah
UK
Asheeta Gupta
UK
Alexey N. Tsygin
Russia
Komiljon Khamzaev
Uzbekistan
Fayzakhmatova Feruza
Uzbekistan
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Approach to Treating Lupus Nephritis in Children
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Kidney involvement is common in lupus and the prognosis depends upon the underlying pathology and optimal and early immunosuppressive treatment. The approach should be based on kidney biopsy data, kidney function and immune tests. Different immunosuppressive regimens are indicated in pathology classes III to V based on steroids, cyclophosphamide, MMF and AZA. Monoclonal antibodies as Rituximab and Belimumab are extensively used in the last decades. The results of clinical trials and guidelines will be discussed.
C3 Glomerulonephritis and Dense Deposit Disease – A Tale of Two Twins
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C3 glomerulopathy is defined by the Consensus Group 2013 as a rare group of kidney disorders due to complement dysregulation. The single diagnostic criteria is dominant C3 deposition in kidney with clinical features of glomerulonephritis (GN). It includes both Dense Deposit Disease (DDD) and C3 GN which have overlapping clinicopathological features. Electron microscopy is necessary to distinguish both. Investigations include tests for complements, antibodies to complement regulating proteins, C3 NeF and genetic analysis. 70% of children and 30 to 50% of adults reach ESKD in 10 years. No treatment is universally effective, though immunosuppression may help.
A tale of two pathologies: Rapidly Progressive Glomerulonephritis and Acute Tubulointerstitial Nephritis
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Open to view video.
Immunosuppression vs post-transplant viral infections: Walking a fine line
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Open to view video.
BK virus (BKV) is a common infection after kidney transplant (KT), with rising prevalence in the era of more potent immunosuppression. Uncontrolled, BKV infection can lead to BK-associated nephropathy, irreversible damage, and graft loss. Concurrent BKV nephropathy and acute rejection is not uncommon, and treatment is challenging. We discuss the case of a child who presented three years after living donor KT with fever, weight loss, GI symptoms, and acute graft dysfunction. Virology screen revealed CMV, BKV, and EBV viremia. Kidney biopsy showed acute cellular rejection. Optimized immunosuppression and antiviral therapy resulted in resolution of viremia and nearly baseline creatinine.
A Challenging Case of Nephrotic Syndrome
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Open to view video.
Nephrotic syndrome refractory to standard treatment poses a challenging problem to paediatric nephrologists. Management issues involve many inter-dependent factors, including fluid status, kidney function, nutrition, infection and thrombosis risks. We will present a case of a child with primary nephrotic syndrome refractory to standard treatment. This session will address common management challenges of a nephrotic child, immunosuppressive strategies and general approach to genetic testing.
The Spectrum of Alport Syndrome: Who and how to investigate?
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Open to view video.
Early diagnosis and pharmacologic intervention can delay progression of chronic kidney disease and the onset of kidney failure in patients with Alport syndrome. We aim to highlight the phenotypic spectrum of this condition through a series of cases. We will cover key updates in diagnostics with a focus on genomics, as well as longer term surveillance and management of patients with Alport syndrome.
Renal amyloidosis presenting as glucocorticoid resistant nephrotic syndrome
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Open to view video.
Amyloidosis is a rare multi-system disease. In children, amyloid A (AA) amyloidosis (previously known as reactive or secondary amyloidosis) may occur due to chronic inflammation. Pediatric AA amyloidosis mainly involves the kidneys and presents with proteinuria, hematuria, hypertension and nephrotic syndrome. Therapy for AA amyloidosis is targeted towards control of the underlying inflammatory disease and suppression of serum amyloid protein production.
In this webinar, we will present a case of renal amyloidosis, successfully treated with IL-6 antibody.