Key Points Infants born with ambiguous genitalia or nonpalpable testes need to be evaluated for congenital adrenal hyperplasia as it can be life threatening. Adrenal steroid levels vary with gestational age. Adrenal insufficiency should be treated with hydrocortisone to avoid…
Key Points Neonatal hypocalcemia may be asymptomatic or present with signs of increased neuromuscular excitability, including focal or generalized seizures. Neonatal hypocalcemia is classified by the timing of onset, with early and late hypocalcemia having different causes and approaches to…
Key Points Developmental disorders of endocrine organs often manifest themselves in the neonatal period. The fetal adrenal gland produces large amounts of androgens to be used by the placenta for estrogen biosynthesis. Neonatal hypopituitarism may be due to a number…
Key Points There are numerous influences on normal blood pressure (BP) in neonates, including gestational age, birthweight, and maternal factors such as preeclampsia. As in older children, identification of hypertension (HTN) in the neonate is dependent on proper BP measurement…
Key Points The presentation of urinary tract infections (UTIs) in neonates differs from that seen in older children. The type and route of infection also differ in neonates, when compared with older children. An appropriate urine sample for diagnosis is…
Key Points Nephrotic syndrome (NS) comprises persistent heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia. Genetic abnormalities of structural or regulatory proteins within the glomerular basement membrane and/or podocyte lead to primary congenital NS (CNS). Treatment of CNS does not involve immunosuppression…
Key Points Kidney development continues until 34 weeks’ gestation. Neonatal intensive care unit graduates, especially those with a history of acute kidney injury (AKI), premature infants, and those with intrauterine growth retardation, are at risk for long-term chronic kidney disease…
Key Points Acute kidney injury (AKI) is common in critically ill neonates. AKI affects survival, hospital expenditures, and long-term outcomes, independent of the severity of illness and comorbidities. Kidney development continues until 34 weeks’ gestation. Neonatal intensive care unit graduates,…
Key Points A voiding cystourethrogram should be performed in infants with high-grade hydronephrosis or bilateral hydronephrosis. Vesicoureteral reflux is more common in male infants and has a high rate of spontaneous resolution. Bladder exstrophy repairs are currently delayed to 3…
Key Points Kidney malformations account for 20% to 30% of all prenatally diagnosed developmental anomalies and are responsible for 31% of all childhood end-stage kidney disease. Patients with unilateral kidney agenesis are at risk for hypertension in childhood and chronic…