title: Renal failure from birth-AKI or CKD? Questions.
abstract: A case is presented of a neonate born at 32 weeks of gestation with intra-uterine growth retardation. The renal scan performed at 31 weeks showed oligohydramnios but normal kidneys. The neonate was oliguric from birth and required early peritoneal dialysis. Her urine showed heavy proteinuria, and the plasma albumin was very low. Post-natal ultrasonography showed large bright kidneys with reduced corticomedullary differentiation but no dysplastia; arterial and venous flow was normal on Doppler ultrasound. The quiz discusses the differential diagnosis with particular reference to whether this picture represents acute kidney injury with expected improvement or chronic kidney disease. Further questions discuss mechanisms of renal failure in this situation. Finally, with reference to previous case reports and series, a correlation between a specific mutation and this severe phenotype is proposed.
authors.affiliation: School of Medicine, University of Nottingham, Nottingham, UK.
authors.forename: Sean
authors.initials: S
authors.lastname: Carter
authors.affiliation: Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Dixit
authors.affiliation: Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lunn
authors.affiliation: Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
authors.forename: Anjum
authors.initials: A
authors.lastname: Deorukhkar
authors.affiliation: Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. martin.christian@nuh.nhs.uk.
authors.forename: Martin
authors.initials: M
authors.lastname: Christian
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000000981:diagnostic imaging; D003241:Consanguinity; D003937:Diagnosis, Differential; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging; D011247:Pregnancy; D051437:Renal Insufficiency / Q000151:congenital* / Q000000981:diagnostic imaging / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging
keywords: Neonate; Oliguria; Renal failure