Learn how pediatric high blood pressure is being missed in busy clinics, why obesity is driving more primary hypertension, and how to properly interpret readings using the 2017 AAP guidelines. The episode also covers ABPM confirmation, red-flag features for secondary causes, and the recommended workup and safety checks before treatment.

Hematuria is a common reason for pediatric nephrology referral, but distinguishing glomerular from non-glomerular causes is the key to building the right differential. In this episode, we walk through a practical approach to pediatric hematuria, beginning with confirmation by urine microscopy and then using urine color, red blood cell morphology, proteinuria, blood pressure, and kidney function to guide the workup.Topics include gross versus microscopic hematuria, false-positive dipsticks, dysmorphic red blood cells, RBC casts, post-streptococcal glomerulonephritis, IgA nephropathy, Alport syndrome, thin basement membrane disease, urinary tract infection, hypercalciuria, nephrolithiasis, Wilms tumor, Nutcracker syndrome, and when to refer to pediatric nephrology.

Selected References:

• Horváth O, Szabó AJ, Reusz GS. How to Define and Assess the Clinically Significant Causes of Hematuria in Childhood. Pediatric Nephrology. 2023.

• Brown DD, Reidy KJ. Approach to the Child With Hematuria. Pediatric Clinics of North America. 2019.

• Expert Panel on Pediatric Imaging; Dillman JR, Rigsby CK, et al. ACR Appropriateness Criteria: Hematuria-Child. Journal of the American College of Radiology. 2018.

• Savige J, Lipska-Ziętkiewicz BS, Watson E, et al. Guidelines for Genetic Testing and Management of Alport Syndrome. Clinical Journal of the American Society of Nephrology. 2022.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

A 4-year-old presents with puffy eyes and foamy urine. In this episode, we review the clinical presentation, key definitions, pathophysiology, initial workup, and biopsy considerations for pediatric nephrotic syndrome.

Topics include steroid-sensitive, steroid-resistant, frequently relapsing, and steroid-dependent nephrotic syndrome; podocyte injury; immune dysregulation; anti-nephrin autoantibodies; APOL1 risk variants; and practical teaching points for medical students, pediatric residents, and early pediatric nephrology fellows.

Coming up next: Complications of nephrotic syndrome.

Correction Note: In this episode, Claire defines frequently relapsing nephrotic syndrome as “two or more relapses within six months or four or more within twelve months.” The correct definition is two or more relapses within six months or three or more within twelve months.

Selected References:

• KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

• IPNA Clinical Practice Recommendations for Steroid-Sensitive Nephrotic Syndrome in Children

• IPNA Clinical Practice Recommendations for Steroid-Resistant Nephrotic Syndrome in Children

Have feedback, corrections, or suggestions for future topics? Email: [email protected]

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, APPs, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is for education only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Bartter and Gitelman syndromes are inherited renal salt-wasting disorders that share many laboratory features but differ in their underlying physiology, clinical presentation, and management. In this episode, we compare these two important tubulopathies using a practical nephron-based approach to help learners understand—not just memorize—their key differences.

Topics include the physiology of the thick ascending limb and distal convoluted tubule, the pathophysiology of Bartter and Gitelman syndromes, interpretation of urine calcium and magnesium, genetic causes, and evidence-based treatment strategies for pediatric patients.

Selected References:

• Seyberth HW, Schlingmann KP. Bartter- and Gitelman-like Syndromes: Salt-Losing Tubulopathies with Loop or Distal Tubule Dysfunction. Physiological Reviews.

• Blanchard A, Bockenhauer D, Bolignano D, et al. Gitelman Syndrome: Consensus and Guidance from ERKNet.Kidney International.

• Konrad M, Nijenhuis T, Ariceta G, et al. Diagnosis and Management of Bartter Syndrome: ERKNet Consensus Recommendations. Nature Reviews Nephrology.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Renal tubular acidosis (RTA) is an important cause of normal anion gap metabolic acidosis in children and should be considered in infants presenting with failure to thrive, vomiting, poor growth, nephrocalcinosis, or persistent electrolyte abnormalities. In this episode, we review the physiology of renal acid-base handling, distinguish the major forms of pediatric RTA, and develop a practical bedside approach to diagnosis.

Topics include distal (Type 1), proximal (Type 2), and hyperkalemic (Type 4) renal tubular acidosis, Fanconi syndrome, inherited causes of RTA, interpretation of the urine anion gap, and evidence-based treatment strategies for pediatric patients.

Selected References:

• Rodríguez-Soriano J. Renal Tubular Acidosis: The Clinical Entity. Journal of the American Society of Nephrology.2002.

• Karet FE. Inherited Distal Renal Tubular Acidosis. Journal of the American Society of Nephrology. 2002.

• Emma F, et al. Clinical Practice Recommendations for the Diagnosis and Management of Inherited Renal Tubular Disorders. Nephrology Dialysis Transplantation.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Hypernatremia can be deceptively difficult to recognize in children, and correcting sodium disorders too quickly can have devastating neurologic consequences. In this episode, we discuss the evaluation and management of pediatric hypernatremia, including neonatal hypernatremic dehydration, central and nephrogenic diabetes insipidus, the post-neurosurgical triphasic response, and practical approaches to fluid replacement.

We also review the emergency management of severe hyponatremia, safe sodium correction rates, the DDAVP clamp, and why frequent laboratory monitoring is far more important than relying solely on correction formulas.

Selected References:

• Zieg J. Hypernatremia in Children. Acta Paediatrica. 2022.

• Sterns RH. Disorders of Plasma Sodium — Causes, Consequences, and Correction. New England Journal of Medicine. 2015.

• Moritz ML. Disorders of Sodium Homeostasis in Children. Pediatric Clinics of North America. 2019.

• Didsbury MS, et al. Rate of Correction of Hypernatremia and Clinical Outcomes in Children. Clinical Journal of the American Society of Nephrology. 2023.

• Adrogué HJ, Madias NE. Hyponatremia. New England Journal of Medicine.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

A child develops headache, vomiting, and confusion after receiving hypotonic IV fluids following surgery. Is this true hyponatremia? Could it be pseudohyponatremia? Or is there another explanation?

In this episode of Kidney Kids: A Guide to Pediatric Nephrology, we explore the evaluation of pediatric hyponatremia, including pseudohyponatremia, hypertonic hyponatremia in diabetic ketoacidosis, and the three major categories of hypotonic hyponatremia based on volume status. We also discuss neonatal physiology, water intoxication, SIADH versus cerebral salt wasting, and the landmark 2018 American Academy of Pediatrics guideline recommending isotonic maintenance IV fluids for most hospitalized children.

Coming up next: Learn how to safely manage hyponatremia—including when to use 3% hypertonic saline, how quickly sodium should be corrected, strategies to prevent osmotic demyelination syndrome, and an approach to pediatric hypernatremia.

Selected References:

• Feld LG, et al. Clinical Practice Guideline: Maintenance Intravenous Fluids in Children. Pediatrics. 2018.

• Moritz ML, Ayus JC. Prevention of Hospital-Acquired Hyponatremia: A Case for Using Isotonic Saline. Pediatrics.

• Adrogué HJ, Madias NE. Hyponatremia. New England Journal of Medicine.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Hemodialysis can seem intimidating at first, but understanding the core principles makes it much easier to approach at the bedside. In this episode, we break down how pediatric hemodialysis works using simple analogies while exploring the clinical concepts every pediatric trainee should know.

Topics include diffusion, ultrafiltration, convection, the dialyzer, vascular access, dialysis adequacy (Kt/V), common complications, and practical bedside pearls for caring for children receiving chronic hemodialysis.

Selected References:

• KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease.

• KDOQI Clinical Practice Guideline for Vascular Access (2019 Update).

• European Society for Paediatric Nephrology (ESPN) Clinical Practice Recommendations for Hemodialysis in Children.

• CONVINCE Trial Investigators. High-Dose Hemodiafiltration versus High-Flux Hemodialysis. New England Journal of Medicine. 2025.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

Once acute kidney injury is recognized, early management can significantly influence both short- and long-term outcomes. In this episode, we discuss the principles of pediatric AKI management, including fluid resuscitation, hyperkalemia, metabolic acidosis, fluid overload, indications for renal replacement therapy, and the unique considerations when choosing a dialysis modality in children.

We also review the growing evidence linking pediatric AKI to chronic kidney disease and why long-term follow-up is essential—even after kidney function appears to recover.

Selected References:

• KDIGO Clinical Practice Guideline for Acute Kidney Injury (2012).

• Ostermann M, et al. Acute Kidney Injury. The Lancet. 2025.

• Selewski DT, et al. The AWARE Study: Fluid Overload and Outcomes in Critically Ill Children. Critical Care Medicine. 2023.

• Gaudry S, et al. Extracorporeal Kidney-Replacement Therapy for Acute Kidney Injury. New England Journal of Medicine. 2022.

• Meena J, et al. Late Outcomes Following Acute Kidney Injury in Children. JAMA Pediatrics. 2026.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.

A rising creatinine can be one of the most stressful calls a pediatric trainee receives overnight. In this episode, we walk through a practical, step-by-step approach to evaluating pediatric acute kidney injury, from the bedside history and physical examination to laboratory testing, urine microscopy, imaging, and knowing when to involve pediatric nephrology.

Topics include interpretation of urine sediment, FENa versus FEUrea, targeted laboratory evaluation, renal ultrasound, emerging AKI biomarkers, and a practical bedside checklist for evaluating children with acute kidney injury.

Coming up next: We'll discuss the management of pediatric acute kidney injury, including fluid resuscitation, fluid overload, indications for kidney replacement therapy, and common management pitfalls.

Selected References:

• KDIGO Clinical Practice Guideline for Acute Kidney Injury (2012).

• Fujita H, et al. Utility of Fractional Excretion of Urea in the Differential Diagnosis of Acute Kidney Injury in Children. Pediatric Nephrology. 2016.

• Abdelhafez M, et al. Diagnostic Performance of Fractional Excretion of Sodium for the Differential Diagnosis of Acute Kidney Injury. Clinical Journal of the American Society of Nephrology. 2022.

• Ostermann M, et al. Acute Kidney Injury. The Lancet. 2025.

• Gaudry S, et al. Extracorporeal Kidney-Replacement Therapy for Acute Kidney Injury. New England Journal of Medicine. 2022.

Have feedback, corrections, or suggestions for future episodes? We'd love to hear from you at [email protected].

Disclaimer: Kidney Kids is an educational podcast for medical students, pediatric residents, pediatric nephrology fellows, advanced practice providers, and practicing clinicians. The conversations use AI-generated voices portraying fictional physicians. This content is intended for educational purposes only and should not replace clinical judgment, institutional protocols, or consultation with qualified healthcare professionals.