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Children
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Advances in Pediatric Renal Diseases
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Advances in Pediatric Renal Diseases

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Nephrology & Urology".

Deadline for manuscript submissions: closed (10 June 2022) | Viewed by 25714

Special Issue Editor

Dr. Anna Di Sessa

E-Mail Website
Guest Editor
Department of Woman, Child and General and Specialized Surgery, University of Studies of Campania "Luigi Vanvitelli", 80138 Napoli, Italy
Interests: pediatric obesity, nutrition, and metabolism; pediatric gastroenterology; pediatric liver diseases; obesity-related comorbidities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

It is a great honor to serve as the Guest Editor for this Special Issue of Children, entitled “Advances in Pediatric Renal Diseases”. Renal diseases in childhood encompass a very wide range of conditions that significantly impact morbidity and mortality later in life. In particular, chronic kidney disease (CKD) is a global public health concern, currently affecting up to 10–15% of the general population. It is a complex, progressive chronic condition that represents a major risk factor not only for end-stage kidney disease but also for cardiovascular disease and other comorbidities.

Given the pathogenic role of the kidney in several biological processes and its involvement in various diseases with growing prevalence worldwide (e.g., diabetes, obesity), there is a need for additional investigation in the field of pediatric renal diseases.

The goal of this Special Issue is to discuss any aspects of pediatric renal diseases to increase our understanding of these conditions, by also sharing knowledge about incompletely understood and controversial areas in this field.

We invite investigators to contribute original research articles, as well as review articles that will stimulate the continuing efforts to improve our understanding in this challenging field. As the title implies, new developments, unconventional, or inspirational contributions are also very encouraged.

We look forward to receiving your contributions

Dr. Anna Di Sessa
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • renal function
  • child
  • adolescent
  • kidney injury
  • treatment
  • management
  • innovations

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Published Papers (7 papers)

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Editorial

Jump to: Research, Review, Other

5 pages, 201 KiB  
Editorial
New Diagnostic Criteria for Hypertension in Children and Adolescents: Lights and Shadows
by Procolo Di Bonito and Anna Di Sessa
Children 2020, 7(11), 196; https://doi.org/10.3390/children7110196 - 24 Oct 2020
Cited by 4 | Viewed by 2049
Abstract
Pediatric hypertension (HTN) represents a challenging disease with a major cardiometabolic risk (CMR) burden from childhood to adulthood. In fact, it has been linked to cardiac and vascular damage even at pediatric age and recognized as an independent risk factor for HTN in [...] Read more.
Pediatric hypertension (HTN) represents a challenging disease with a major cardiometabolic risk (CMR) burden from childhood to adulthood. In fact, it has been linked to cardiac and vascular damage even at pediatric age and recognized as an independent risk factor for HTN in adulthood. Therefore, HTN in children has gained remarkable scientific interest during the past decades. However, the availability of different diagnostic classifications complicates HTN definition. The Clinical Practice Guidelines released in 2017 updated the diagnostic criteria, by highlighting some important issues with clinical implications. Lowering the new cut-offs proposed by the CPG, as compared with those proposed by IV Report criteria, will increase the number of young people at risk of hypertension. However, evidence suggests that the CPG cutoff-points in further identifying subjects with an altered CMR profile. Currently, some issues are still debated such as the adoption of a fixed cut-off of BP ≥ 130/80 mmHg for children aged ≥ 13 years, or the adoption of criteria for cardiac damage derived from adults. Given the CMR burden of pediatric HTN, a better and early identification of children at higher HTN risk is strictly recommended in order to improve HTN management to reduce the cardiovascular risk in these youths. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)

Research

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10 pages, 260 KiB  
Article
Transition of Chronic Pediatric Nephrological Patients to Adult Care Excluding Patients on Renal Replacement Therapy with Literature Review
by Mirjam Močnik, Sonja Golob Jančič and Nataša Marčun Varda
Children 2022, 9(7), 959; https://doi.org/10.3390/children9070959 - 26 Jun 2022
Cited by 2 | Viewed by 2015
Abstract
(1) Background: The transition of children with chronic kidney disease to adult care has become a well-handled issue. However, other patients with normal or mildly decreased renal function also requiring further management and transition are neglected. (2) Methods: A questionnaire was sent to [...] Read more.
(1) Background: The transition of children with chronic kidney disease to adult care has become a well-handled issue. However, other patients with normal or mildly decreased renal function also requiring further management and transition are neglected. (2) Methods: A questionnaire was sent to patients with kidney pathology, aged 17 years and older.(3) Results: The patients were mostly high-school (55%) or college students (39%), living with their parents (94%). One third did not know how their disease affected their choice of profession and reproductive health. Furthermore, 46% of the respondents did not know who would continue with their care, and 44% still had a primary pediatrician. (4) Conclusions: A review of the literature on the topic was performed and summarized here. Regular education is the key for successful transfer, not only in chronic kidney and transplant patients, but also in others in whom a decline in renal function can be expected in the future. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
12 pages, 805 KiB  
Article
Patterns of Urinary Neutrophil Gelatinase-Associated Lipocalin and Acute Kidney Injury in Neonates Receiving Cardiopulmonary Bypass
by Kathleen G. Brennan, Elvira Parravicini, John M. Lorenz and David A. Bateman
Children 2020, 7(9), 132; https://doi.org/10.3390/children7090132 - 9 Sep 2020
Cited by 5 | Viewed by 2496
Abstract
Elevated urinary neutrophil gelatinase-associated lipocalin (uNGAL) predicts acute kidney injury (AKI) in children following cardiopulmonary bypass (CPB) during cardiac surgery, but little is known about uNGAL’s predictive ability in neonates in this setting. We sought to determine the relationship between AKI and post-CPB [...] Read more.
Elevated urinary neutrophil gelatinase-associated lipocalin (uNGAL) predicts acute kidney injury (AKI) in children following cardiopulmonary bypass (CPB) during cardiac surgery, but little is known about uNGAL’s predictive ability in neonates in this setting. We sought to determine the relationship between AKI and post-CPB uNGAL in neonates in the first 72 post-operative hours. Methods: Urine samples for uNGAL analysis were collected at preoperative baseline and serially post-operatively from 76 neonates undergoing CPB. Mixed-effects regression models and logistic models assessed associations between uNGAL and AKI (controlling for sex, gestational age, CPB time, surgical complexity, and age at surgery). Receiver-operator curves were applied to define optimal uNGAL cut-off values for AKI diagnosis. Results: Between 0 and 4 h post-operatively, uNGAL values did not differ between neonates with and without AKI. After 4 h until 16 h post-operatively, significant time-wise separation occurred between uNGAL values of neonates with AKI and those without AKI. Odds ratios at each time point significantly exceeded unity, peaking at 10 h post-operatively (3.48 (1.58, 8.71)). Between 4 and 16 h post-operatively, uNGAL discriminated AKI from no-AKI, with a sensitivity of 0.63 (0.49, 0.75) and a specificity of 0.68 (0.62, 0.74) at a cut-off value of 100 ng/mL. Conclusion: After 4 h until 16 h post-operatively, elevated uNGAL is associated with AKI in neonates receiving CPB during cardiac surgery; however, this relationship is more complex than in older children. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
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Review

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14 pages, 319 KiB  
Review
New Insights from Metabolomics in Pediatric Renal Diseases
by Simona Riccio, Maria Sole Valentino, Antonio Paride Passaro, Marica Izzo, Stefano Guarino, Emanuele Miraglia del Giudice, Pierluigi Marzuillo and Anna Di Sessa
Children 2022, 9(1), 118; https://doi.org/10.3390/children9010118 - 17 Jan 2022
Cited by 9 | Viewed by 3286
Abstract
Renal diseases in childhood form a spectrum of different conditions with potential long-term consequences. Given that, a great effort has been made by researchers to identify candidate biomarkers that are able to influence diagnosis and prognosis, in particular by using omics techniques (e.g., [...] Read more.
Renal diseases in childhood form a spectrum of different conditions with potential long-term consequences. Given that, a great effort has been made by researchers to identify candidate biomarkers that are able to influence diagnosis and prognosis, in particular by using omics techniques (e.g., metabolomics, lipidomics, genomics, and transcriptomics). Over the past decades, metabolomics has added a promising number of ‘new’ biomarkers to the ‘old’ group through better physiopathological knowledge, paving the way for insightful perspectives on the management of different renal diseases. We aimed to summarize the most recent omics evidence in the main renal pediatric diseases (including acute renal injury, kidney transplantation, chronic kidney disease, renal dysplasia, vesicoureteral reflux, and lithiasis) in this narrative review. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
13 pages, 1125 KiB  
Review
Asymmetric Dimethylarginine (ADMA) in Pediatric Renal Diseases: From Pathophysiological Phenomenon to Clinical Biomarker and Beyond
by Chien-Ning Hsu and You-Lin Tain
Children 2021, 8(10), 837; https://doi.org/10.3390/children8100837 - 24 Sep 2021
Cited by 11 | Viewed by 3297
Abstract
Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide (NO) synthase inhibitor, inhibits NO synthesis and contributes to the pathogenesis of many human diseases. In adults, ADMA has been identified as a biomarker for chronic kidney disease (CKD) progression and cardiovascular risk. However, little attention [...] Read more.
Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide (NO) synthase inhibitor, inhibits NO synthesis and contributes to the pathogenesis of many human diseases. In adults, ADMA has been identified as a biomarker for chronic kidney disease (CKD) progression and cardiovascular risk. However, little attention is given to translating the adult experience into the pediatric clinical setting. In the current review, we summarize circulating and urinary ADMA reported thus far in clinical studies relating to kidney disease in children and adolescents, as well as systematize the knowledge on pathophysiological role of ADMA in the kidneys. The aim of this review is also to show the various analytical methods for measuring ADMA and the issues tht need to be addressed before transforming to clinical practice in pediatric medicine. The last task is to suggest that ADMA may not only be suitable as a diagnostic or prognostic biomarker, but also a promising therapeutic strategy to treat pediatric kidney disease in the future. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
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14 pages, 965 KiB  
Review
Update on the Classification and Pathophysiological Mechanisms of Pediatric Cardiorenal Syndromes
by Giorgia Ceravolo, Tommaso La Macchia, Caterina Cuppari, Valeria Dipasquale, Antonella Gambadauro, Celeste Casto, Maria Domenica Ceravolo, Maricia Cutrupi, Maria Pia Calabrò, Paola Borgia, Gianluca Piccolo, Alessio Mancuso, Remo Albiero and Roberto Chimenz
Children 2021, 8(7), 528; https://doi.org/10.3390/children8070528 - 22 Jun 2021
Cited by 8 | Viewed by 4073
Abstract
Cardiorenal syndrome (CRS) is defined as a disorder resulting from the abnormal interaction between the heart and kidney, in which acute or chronic dysfunction of one organ may lead to acute and/or chronic dysfunction of the other. The functional interplay between the heart [...] Read more.
Cardiorenal syndrome (CRS) is defined as a disorder resulting from the abnormal interaction between the heart and kidney, in which acute or chronic dysfunction of one organ may lead to acute and/or chronic dysfunction of the other. The functional interplay between the heart and kidney is characterized by a complex bidirectional symbiotic interaction, regulated by a wide array of both genetic and environmental mechanisms. There are at least five known subtypes of CRS, based on the severity of clinical features and the degree of heart/renal failure. The fourth subtype (cardiorenal syndrome type 4 (CRS4)) is characterized by a primary chronic kidney disease (CKD), which in turn leads to a decreased cardiac function. Impairment of renal function is among the most important pathophysiological factors contributing to heart failure (HF) in the pediatric age group, and cardiovascular complications could be one of the most important causes of mortality in pediatric patients with advanced CKD. In this context, a loss of glomerular filtration rate directly correlates with both the progression of cardiovascular complications in CRS and the risk of HF. This review describes the interaction pathways between the heart and kidney and the recently identified pathophysiological mechanisms underlying pediatric CRS, with a special focus on CRS4, which encompasses both primary CKD and cardiovascular disease (CVD). Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
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Other

12 pages, 1710 KiB  
Case Report
A Rare Cause of Chronic Hypokalemia with Metabolic Alkalosis: Case Report and Differential Diagnosis
by Cristina Bertulli, Marguerite Hureaux, Chiara De Mutiis, Andrea Pasini, Detlef Bockenhauer, Rosa Vargas-Poussou and Claudio La Scola
Children 2020, 7(11), 212; https://doi.org/10.3390/children7110212 - 5 Nov 2020
Cited by 8 | Viewed by 6816
Abstract
Hypokalemia and metabolic alkalosis can be present in different rare diseases, and the differential diagnosis of these forms is challenging. Apparent mineralcorticoid (AME) excess syndrome is one of these conditions. Characterized by increased blood pressure due to excessive sodium retention and plasma volume, [...] Read more.
Hypokalemia and metabolic alkalosis can be present in different rare diseases, and the differential diagnosis of these forms is challenging. Apparent mineralcorticoid (AME) excess syndrome is one of these conditions. Characterized by increased blood pressure due to excessive sodium retention and plasma volume, it is caused by a mutation in the HSD11B2 gene encoding the oxydoreductase enzyme 11β-hydroxysteroide dehydrogenase type 2. We report the case of a child presenting with failure to thrive associated with early detection of hypokalemia, metabolic alkalosis, nephrocalcinosis and hypertension in which AME syndrome was detected. A novel mutation in the HSD11B2 gene was identified in this patient. In clinical pictures characterized by metabolic alkalosis and hypokalemia, the evaluation of renin, aldosterone and blood pressure is crucial for accurate diagnosis. AME syndrome is a rare disorder that can be an insidious but lethal disease, if untreated. With clinical signs appearing during the first days of life. Early diagnosis is imperative in order to enable prompt and adequate treatment to improve the outcome of these patients. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
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