Monday, August 22, 2016

Hello Kidney

Just finished my month as senior resident on the Inpatient Kidney Service. Incredibly busy with very sick children all month. Learned a lot, worried a ton. Now have several more grey hairs and probably need a new eyeglass prescription. It's worth it though, I'd do anything for these kids, they are AMAZING. And ridiculously cute.

In case you don't know, the kidneys are really important to every day life.  A litany of potential problems, and possibly all at the same time! Hyperkalemia, Hyponatremia, Hypocalcemia, Anemia, Hypertension, Uremia, Hypertriglyceridemia, Hyperphosphatemia, Proteinuria, Hypoalbuminemia, Thrombosis, Infection, the list goes on...

Any little thing can go wrong when you have kidneys that don't work very well, especially when you are small. Many of our children with severe kidney disease live for years on dialysis until they are big enough for a kidney or until they find a matched kidney donor.

Try to imagine..

  • Having a little baby and needing to connect them to peritoneal dialysis every night for 12 hours a night. 
  • Trying to give a toddler 10 medicines every single day, and they taste bad.
  • Your tween-age sister needing urgent dialysis for kidney failure because of a diarrheal illness a week ago
  • Every time your school-aged kiddo has a fever they needed to be hospitalized to rule out a serious bacterial infection

A few acronyms from the month:

Electron Microscopy of Kidney's Glomerulus. Thx WikiCommons!

Kids with chronic kidney problems are at higher risk of infections than us regular folk -whether it be from immunosuppressive medicines to preserve their kidney transplant, extra fluid that can get infected or having a central line/catheter that puts them at risk for infection. Just in case you weren't a germ-a-phobe already, here's a list of the infections I've dealt with recently:

  • Adenoviremia
  • CMV colitis
  • Cryptosporidiosis
  • Clostridium difficile colitis
  • Enterococcus faecalis bacteremia
  • Infectious Mononucleosis
  • Streptococcus pneumoniae meningitis
  • Ecoli O157H7 

Bottomline: The next time you pee, thank your kidneys. They don't get enough credit for all their hard work!

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