Therefore, it is important not to underestimate the clinical state. A difference of 0.1 mg/dl of serum Cr may be

significant. An estimation formula of kidney function applicable to children is now under development by the Japanese Society of Pediatric Nephrology. For the time being, using the estimating measures shown below or Schwartz’s equation is recommended. Rough standard CUDC-907 values of serum creatinine in the child: 0.2 mg/dl or so for a 1-year-old child; 0.3 mg/dl for a 4-year-old child; 0.4 mg/dl for a 10-year-old child. Schwartz’s formula can be applied for estimation of GFR. Schwartz’s formula (applicable for children 2 years or older and younger than 12 years) Estimated GFR (mL/min/1.73 m 2 ) = height (cm) × 0.55/(serum Cr + 0.2) learn more Note: the serum creatinine value is added with 0.2 to convert a value measured by the enzyme method to that by the Jaffe method. Normal blood pressure values for children differ

from those for adults: 95–110/60–75 mmHg for 3–6 years of age and 100–120/60–75 mmHg for 6–12 years. Unlike in adults, it is rare for a malignant tumor to be found in a group with mild hematuria alone. Not infrequently, protein is excreted in the urine in cases of orthostatic proteinuria or postural proteinuria. Therefore, urine should be collected not only at a medical office, but also at home as the morning first urine. Diagnosis Tideglusib chemical structure and treatment of primary disease When urinary abnormality or kidney dysfunction is found, a patient should be examined for hypoplastic/dysplastic kidney and hydronephrosis by ultrasonography. Renal biopsy is considered in cases where there is: 0.5–1.0 g protein/m2/day (per day/per unit body surface area), whih is comparable to >2+ in the morning urine for 3–6 months and 1.0 g or over protein/m2/day for 3 months. It is recommended that

a patient be referred without delay to a pediatric nephrologist when both proteinuria and hematuria are found or when edema as well as hypertension is present. A patient with isolated hematuria is managed for diagnosis according to Guidelines for the Diagnosis of Hematuria (the Japanese Urological Association, the Japanese Society of Nephrology, and the Japanese Society of Pediatric Nephrology) (Fig. 11-1). Fig. 11-1 A diagnostic flowchart of hematuria in children. Y-27632 manufacturer The data are quoted, with modification, from: The guidelines for diagnosis of hematuria edited by the Japanese Urological Association, the Japanese Society of Nephrology and the Japanese Society of Pediatric Nephrology After making a diagnosis of CKD, follow-up is carried out according to the protocol illustrated in Fig. 11-2 until a proper time of referral to a nephrologist. It should be remembered that treatment as well as follow-up of pediatric CKD is different from that for adults. Kidney diseases seen in children are listed in Table 11-1. Fig.