Pediatric CCRN Renal Flashcards

According to KDIGO criteria, which urine output threshold defines oliguria and indicates acute kidney injury (AKI) in a pediatric patient?

Answer: < 0.5 mL/kg/hr for 6 hours

KDIGO criteria define oliguria as urine output < 0.5 mL/kg/hr for 6 or more consecutive hours, which is a diagnostic criterion for AKI staging.

A 4-year-old presents with bloody diarrhea, thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury. What is the most likely diagnosis?

Answer: Hemolytic uremic syndrome

The classic triad of microangiopathic hemolytic anemia, thrombocytopenia, and AKI following bloody diarrhea is the hallmark presentation of hemolytic uremic syndrome (HUS).

Which is the FIRST-LINE treatment for life-threatening hyperkalemia (K+ > 6.5 mEq/L with ECG changes) in a pediatric patient?

Answer: Calcium gluconate IV

Calcium gluconate is administered first in life-threatening hyperkalemia because it immediately stabilizes the cardiac membrane, reducing the risk of fatal arrhythmias.

A 7-year-old with nephrotic syndrome has periorbital edema and a serum albumin of 1.5 g/dL. What is the PRIMARY pathophysiology of edema in nephrotic syndrome?

Answer: Decreased plasma oncotic pressure

Massive proteinuria leads to hypoalbuminemia, which reduces plasma oncotic pressure and allows fluid to leak into the interstitial space, causing edema.

What is the correct maintenance fluid requirement for a 20 kg child using the Holliday-Segar method?

Answer: 1,500 mL/day

Using the 100-50-20 rule: 100 mL/kg × 10 kg = 1,000 mL + 50 mL/kg × 10 kg = 500 mL, totaling 1,500 mL/day.

In continuous renal replacement therapy (CRRT), which modality removes solutes through BOTH convection and diffusion?

Answer: Continuous venovenous hemodiafiltration (CVVHDF)

CVVHDF combines convection (via ultrafiltration/hemofiltration) and diffusion (via dialysate), maximizing solute clearance across all molecular sizes.

A child with AKI has a serum sodium of 122 mEq/L and is actively seizing. What is the most appropriate immediate intervention?

Answer: 3% hypertonic saline bolus

Symptomatic severe hyponatremia with seizures requires urgent correction using 3% hypertonic saline to raise serum sodium by 1–2 mEq/L/hr until symptoms resolve.