Acute kidney injury as the onset of cystic fibrosis in a child of 1 year of age

Author:

Safina A. I.1ORCID,Mikhailova T. V.1ORCID,Zakirov I. I.1ORCID,Suleimanova I. M.2ORCID

Affiliation:

1. Kazan State Medical Academy, Branch Campus of the Medical Academy of Continuous Professional Education

2. City Children’s Hospital No. 1

Abstract

Early diagnosis of the cystic fibrosis remains an urgent problem, despite ongoing nationwide neonatal screening. The uniqueness of the presented clinical case lies in the atypical onset of cystic fibrosis in a young child with clinical manifestations of acute kidney injury. The suddenly developed severe general condition in a child was due to manifestations of acute renal injury of the third stage (severe lethargy, anuria for 14 hours, an increase in blood creatinine to 121 µmol/L, a decrease in glomerular filtration rate to 17.4 mL/min), decompensated metabolic alkalosis with hypokalemia, hyponatremia, hypocalcemia (pH 7.6, K+ 2.6 mmol/L, Na+ 118 mmol/L, Ca2+ 0.96 mmol/L, HCO3 – 35.5 mmol/L). The observed disturbances in acid-base status and electrolyte metabolism were manifestations of the pseudo-Bartter syndrome. For the prevention of acute kidney injury in a patient with cystic fibrosis, timely electrolyte and fluid management is important to prevent the development of pseudo-Bartter’s syndrome, exsicosis and hypovolemia.

Publisher

The National Academy of Pediatric Science and Innovation

Subject

Pediatrics, Perinatology and Child Health

Reference9 articles.

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3. Fremont O.T., Chan J.C.M. Understanding Bartter syndrome and Gitelman syndrome. World J Pediatr 2012; 8(1): 25–30. DOI: 10.1007/s12519–012–0333–9

4. Yalçin E., Kiper N., Doğru D., Ozçelik U., Aslan A.T. Clinical features and treatment approaches in cystic fibrosis with pseudo-Bartter syndrome. Ann Trop Paediatr 2005; 25: 119–124. DOI: 10.1179/146532805X45719

5. Peremans L., Declercq D., Vande Velde S., De Bruyne R., Van Winckel M., Vande Walle J. et al. Acid-base disturbances in dehydrated patients with cystic fibrosis: four case reports with review of literature. Acta Gastroenterol Belg 2020; 83(2): 315–318

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