Renal imaging in children with chronic kidney disease

  • Wiwit Rahmawati Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital
  • Heru Muryawan Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital
  • Farah Prabowo Department of Child Health, Diponegoro University Medical School/Dr. Kariadi Hospital
Keywords: chronic kidney disease, renal imaging, mortality

Abstract

Background Chronic kidney failure is a cause of death in
children. Diagnosing chronic kidney disease is often made by
clinical manifestations, laboratory findings and ultrasonography
or other imaging tests. Early detection of chronic kidney disease
is needed for education and management of the disease.
Objective To describe renal imaging findings and mortality in
children with chronic kidney disease .
Methods This was a cross-sectional study on children with kidney
diseases who were inpatients at Dr. Kariadi Hospital from January
2008 to June 2011. Data were taken from medical records. Chronic
kidney disease was confirmed by clinical manifestations, laboratory
findings, and radiologic imaging. Renal ultrasound findings were
determined by the radiologist responsible at that time. Results
were presented as ft:equency distributions.
Results Of 37 chronic kidney disease cases, 27 were males and 10
were females. Subjects' most common complaints were dyspnea (7
out of 3 7) and edema (30 out of 3 7) . Renal ultrasound imaging of
subjects with chronic kidney disease yielded the following findings:
reduced cortico-medullary differentiation (30 out of 3 7), bilateral
echogenic kidneys (21 out of 3 7), reduced renal cortex thickness
(4 out of 37) and small-sized kidneys (4 out of 37) . Eight of the
37 children died. These 8 subjects had the following radiologic
imaging findin gs: both kidneys appeared small in size (4 out ofS),
reduced 'renal cortex' thickness (4 out of 8), echogenic kidneys
(6 out of 8), and reduced cortico-medullary differentiation (8
out of8).
Conclusion Renal ultrasound imaging of pediatric subjects with
chronic kidney disease revealed findings of reduced corticomedullary
differentiation, bilateral echogenic kidneys, reduced
renal cortex thickness, and small kidneys bilaterally.

References

1. Hogg RJ, Furth S, Lemley KY, Portman R, Schwartz GJ, Coresh
J, et al.National Kidney Foundation's Kidney Disease Outcomes
Quality Initiative clinical practice guidelines for chronic kidney
disease in children and adolescents: evaluation, classification,
and stratification. Pediatrics. 2003;1 l 1;1416-21.
2. Arora P. Chronic renal failure. Medscape reference:
Drugs, disease & procedures. 2011 June [cited 2011 July
3]. Available from http ://emedicine.medscape.com/
article/238798-overview.
3. Whyte DA, Fine RN. Chronic kidney disease in children.
Pediatr Rev. 2008;29 :335-41.
4. Avner D. Urology imaging. In: Kuhn JP, Slovis TL, Haller
JO, editors. Caffey's pediatric diagnostic imaging. 10th ed.
Philadelphia: Elsevier; 2004. p. 1818-9.
5. Collins AJ, Foley RN, Herzog C, Chavers BM, Gilbertson
D, Ishani A, et al. Excerpts from the United States Renal
Data System 2007 annual data report. Am J Kidney
Dis.2008;5 l:Sl - 320.
6. Ardissino G, Dacco V, Testa S, Bonaudo R, Appiani AC,
Taioli E, et al. Epidemiology of chronic renal failure in
children: Data from the ItalKid project. Pediatrics. 2003;
ll l :e382-7.
7. Gonzales Celedon C, Bitsori M, Tullus K. Progression of
chronic renal failure in children with dysplastic kydneys.
Pediatr Nephrol. 2007;22:1014-20.
8. Seikaly MG, Ho PL, Emmett L, Fine RN, Tejani A. Chronic
renal insufficiency in children: The 2001 Annual Report of
the NAPRTCS. Pediatr Nephrol. 2003; 18:796-804.
9. Craven A-M, Hawley CM, McDonald SP, Rosman JB, Brown
FG, Johnson DW. Predictors of renal recovery in Australian
and New Zealand end-stage renal failure patients treated
with peritoneal dialysis. Peritoneal Dialysis International.
2007;27 (2): 184- 191.
10. (Best Evidence) Choi AI, Rodriguez RA, Bacchetti P,
Bertenthal D, Hernandez GT, O'Hare AM. White/black
racial differences in risk of end-stage renal disease and death.
AmJ Med. 2009; 122:672-8.
11. Gulati S. Chronic kidney disease in children. Medscape
reference: Drugs, disease & procedures. 20 11 June 21
[cited 2011 October 10]. Available from: http://emedicine.
medscape.com/article/984358-overview#showall.
12. Rigden SPA. The management of chronic and end stage renal
failure in children. In Clinical paediatric nephrology. Webb
NJA, Postlethwaite RJ, editors. 3rd ed. New York: Oxford
University; 2003 . p. 427-9.
13. Lewis M. Report of the Paediatric Renal Registry 1999. In:Ansell D, Feest T, editors. UK Renal Registry, Bristol, UK.
Chapter 15. p. 175-87.
14. Ebsjorner E, Berg U, Hansson S, writing on behalf of the
Swedish Pediatric Nephrology Association. Epidemiology
of chronic renal failure in children: A report from Sweden
1986-1994. Pediatr Nephrol 1997;11:438-42
15. North American Pediatric Renal Trials and Collaborative
Studies. NAPRTCS 2007 Annual Report. Chronic Renal
Insufficiency. Section 13. p. 1-18.
16. Peterson AC. Urologic imaging without x-rays - ultrasonography,
MRI, and nuclear medicine. Medscape reference:
Drugs, disease & procedures. 2008 November 21. [ cited 2011
October 10]. Available from: http://emedicine.medscape.
com/article/455553-overview.
17. Radermacher J. Ultrasonography of the kidney and renal
vessels. I. Normal findings, inherited and parenchymal
diseases. Urologe A. 2005 ;44: 13 51-63.
18. Moccia WA, Kaude JV, Wright PG, Gaffney EF. Evaluation
of chronic renal failure by digital gray-scale ultrasound. Urol
Radiol. 1980;2:1-7.
Published
2013-08-31
How to Cite
1.
Rahmawati W, Muryawan H, Prabowo F. Renal imaging in children with chronic kidney disease. PI [Internet]. 31Aug.2013 [cited 29Mar.2024];53(4):193-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/280
Section
Articles
Received 2016-08-21
Accepted 2016-08-21
Published 2013-08-31