Biomedical subjects
Publications and source records attributed to Ivy I Boydstun.
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Chronic kidney disease (CKD) involves a fixed deficit or progressive deterioration in kidney function, producing variable losses of normal physiologic functions. In adolescents, CKD results from a wide range of causes. Because of the broad spectrum of disease, the physician providing primary care to the adolescent must be knowledgeable about findings leading to the diagnosis of CKD and must understand the physiologic basis for therapeutic management. Complications of normal renal function loss include issues of fluid, electrolyte, and acid-base balance, as well as development of anemia, cardiovascular disease, metabolic bone disease, and growth failure. Goals of therapy include anticipation and replacement of lost physiologic functions so that the adolescent can grow and develop normally.
Acute renal failure (ARF) can be defined as the sudden loss of adequate renal function to clear metabolic wastes and maintain normal fluid and electrolyte balance. ARF may occur in otherwise healthy children, may complicate underlying chronic kidney disease, or may result from multiorgan disorders. The underlying cause of the renal injury remains the major factor that determines outcomes for patients with ARF. Overall mortality in children with ARF varies from 8% to 89%, with greater than 50% mortality associated with three-organ system failure. Management of the adolescent with ARF ranges from conservative management in mild cases to more intensive care in hospitalized patients with complications of fluid overload, hypertension, metabolic acidosis, or life-threatening hyperkalemia.