• Robert S. Holzman
  • Thomas J. Mancuso
  • Navil F. Sethna
  • James A. DiNardo


A 3-month-old male, 4.2 kg with chronic obstructive nephropathy as a result of bilateral megaureter presents for megaureter repair and bilateral ureteral reimplant. His hematocrit is 29%, with electrolytes Na+ = 132 meq/dL, K+ = 4.0 meq/dL, Cl = 103 meq/dL, HCO3 = 19 meq/dL, BUN = 8 mg%, and Cr = 1.7 mg%. He is on sulfamethoxazole/trimethoprim once a day. Heart rate is 110 bpm, BP 110/70 mmHg, and RR 20/min.


Fatigue Catheter Morphine Angiotensin Bicarbonate 

General References

  1. 1.
    Roth KS, Koo HP, Spottswood SE, Chan JC (2002) Obstructive uropathy: an important cause of chronic renal failure in children. Clin Pediatr (Phila) 41:309–314CrossRefGoogle Scholar
  2. 2.
    Laing CM, Toye AM, Capasso G, Unwin RJ (2005) Renal tubular acidosis: developments in our understanding of the molecular basis. Int J Biochem Cell Biol 37:1151–1161PubMedCrossRefGoogle Scholar
  3. 3.
    Salusky IB, Kuizon BG, Juppner H (2004) Special aspects of renal osteodystrophy in children. Semin Nephrol 24:69–77PubMedCrossRefGoogle Scholar
  4. 4.
    D’Addessi A, Bongiovanni L, Racioppi M, Sacco E, Bassi P (2008) Is extracorporeal shock wave lithotripsy in pediatrics a safe procedure? J Pediatr Surg 43:591–596PubMedCrossRefGoogle Scholar
  5. 5.
    Sanchez CP (2008) Mineral metabolism and bone abnormalities in children with chronic renal failure. Rev Endocr Metab Disord 9:131–137PubMedCrossRefGoogle Scholar
  6. 6.
    Holder JP (1989) Pathophysiologic and anesthetic correlations of the prune-belly syndrome. AANA J 57:137–141PubMedGoogle Scholar
  7. 7.
    Donckerwolcke R, Yang WN, Chan JC (1989) Growth failure in children with renal tubular acidosis. Semin Nephrol 9:72–74PubMedGoogle Scholar
  8. 8.
    Martinez JR, Grantham JJ (1995) Polycystic kidney disease: etiology, pathogenesis, and treatment. Dis Mon 41:693–765PubMedCrossRefGoogle Scholar
  9. 9.
    Kemper MJ, Harps E, Muller-Wiefel DE (1996) Hyperkalemia: therapeutic options in acute and chronic renal failure. Clin Nephrol 46:67–69PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Robert S. Holzman
    • 1
  • Thomas J. Mancuso
    • 1
  • Navil F. Sethna
    • 1
  • James A. DiNardo
    • 1
  1. 1.Children’s Hospital BostonHarvard Medical SchoolBostonUSA

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