A 6-year-old boy was referred due to abnormal kidney function tests performed following vomiting and diarrhea lasting for 5 days before admission. The family denied a decrease in urine. There was no consanguinity between the parents nor did he have a known disease in his medical history. In his medical records, his serum creatinine was 0.6 mg/dL 6 months prior to admission. He had a body weight of 21.4 kg (25th–50th percentile), height of 118.5 cm (25th–50th percentile), body temperature of 36.7 °C, blood pressure of 158/100 mmHg (> 95th percentile +12), heart rate of 104/min, and respiratory rate of 26/min. The patient was oriented and cooperative. In his physical examination, he had +1 pretibial pitting edema. Respiratory sounds were normal. There was no splenomegaly or hepatomegaly. Laboratory tests are shown in Table
1.
Table 1
Laboratory values of the patient at the admission
|
Serum urea
|
198 mg/dL (N: 10–38)
|
|
Creatinine
|
6.2 mg/dL (N: 0.5–1.2)
|
|
Uric acid
|
6.4 mg/dL (N: 2–5.5)
|
|
Albumin
|
2.3 g/dL (N: 3.5–5.5)
|
|
Sodium
|
130 mmol/L (N: 134–150)
|
|
Potassium
|
4.91 mmol/L (N: 3.5–5.5)
|
|
Calcium
|
7.7 mg/dL (N: 8.8–10.8)
|
|
Phosphorus
|
6.6 mg/dL (N: 4–7)
|
|
Erythrocyte sedimentation rate (ESR)
|
108 mm/h (N: 0–20)
|
|
Parathormone
|
248 ng/L (N: 18.5–88)
|
|
C-reactive protein
|
4.6 mg/L (N: 0–5)
|
|
Blood gass
|
pH 7.13, pCO2 48 mmHg, HCO3 11.6 mmol/L, and BE − 16.7 mmol/L
|
|
Serum C3
Serum C4
|
1.23 g/L (N: 0.9–1.8)
0.3 g/L (N: 0.1–0.4)
|
|
IgG
IgA
IgM
IgE
|
8.44 g/L (N: 7–16)
1.75 g/L (N: 0.7–4)
0.76 g/L (N: 0.4–2.3)
24,600 IU/mL (N: 0–90)
|
|
Rheumatoid factor
ANA/anti-ds DNA
Extractable nuclear antigen (ENA) panel
c-ANCA/p-ANCA
Anti-glomerular basement membrane antibody
Phospholipase-A2 receptor antibody
|
Negative
Negative/negative
Negative
Negative/negative
Negative
Negative
|
|
Urine analysis
|
Specific gravity 1018; glucose +2; protein + 3; erythrocytes +2
|
|
Spot urine protein/creatinine
|
24.4
|
|
Tubular tests
|
|
FeNa
|
3.1%
|
|
FeK
|
172%
|
|
TPR
|
45.6%
|
…
