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Pediatric Nephrology

Disorders Are Growing Concern in Eastern North Carolina By Hsiao L. Lai, M.D.; Basema Dibas, M.D.; and Guillermo Hidalgo, M.D.

Pediatric patients with nephrologic disor-

inherited or developmental disorders to-

ders are a unique population with com-

ward an increasing proportion of children

plex medical needs who often require

referred for primary hypertension, renal

specialized dietary, social, financial and

hyperfiltration and metabolic syndrome.

educational support services.

These children are at much higher risk of developing diabetes and progressive

Many of these patients have underlying

renal disease.

developmental or genetic disorders, in

Dr. Guillermo Hidalgo, Dr. Hsiao Lai and Dr. Basema Dibas are pediatric nephrology specialists with ECU. Dr. Hidalgo is a boardcertified pediatrician and associate professor. He can be reached at (252) 744-5437 or Dr. Lai is board certified in internal medicine, pediatrics, nephrology and pediatric nephrology and an assistant professor. She can be reached at (252) 744-2545. Dr. Dibas is board certified in pediatrics and a clinical assistant professor. She can be reached at (252) 744-5437.

addition to their kidney disease, which

Eastern North Carolina has a particularly

warrant multidisciplinary care. In the

high burden of diabetes, hypertension

past, dysplastic and developmental dis-

and obesity. This affects not only the

betes in the 22-40 year-old age group are

orders of the kidney and urogenital tract



accelerating, while stable or declining in

were the leading causes of kidney disease

these disorders are being discovered in

all other age groups, aside from patients

that progressed to end-stage renal disease

adolescents and school-age children.

75 years or older.

According to the National Health and Nu-

The true prevalence of patients with

Recently, the spectrum of pediatric renal

tritional Examination Survey (NHANES),

kidney disease is unknown. Because of

disease has changed from predominantly

the rates of incident ESRD related to dia-

this, it is difficult to accurately estimate




how many of these individuals progress to advanced stages of chronic kidney disease (CKD) or to kidney failure. Young patients with kidney disease suffer high morbidity and mortality, especially if there is a delay in disease detection. Fortunately, new standardized equations for





in children is allowing the medical community to better detect and monitor early kidney disease in a more uniform fashion. Pediatric nephrology in eastern North Carolina has been a presence since 1983. Between 1983 and 2003, there was a sustained patient base of about 800 patients. Although in general pediatricaged patients comprise only about


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The Eastern Physician March 2012  

The Eastern Physician March 2012

The Eastern Physician March 2012  

The Eastern Physician March 2012