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Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Society of Pediatric Nephrology – SINePe

The incidence of isolated microhaematuria in random urine testing is about 8% in children of 3 years of age; this percentage falls to 3-4% in schoolchildren. Nevertheless, in both of these paediatric age groups, the incidence of microhaematuria at subsequent urinalysis falls significantly to 0.7-1.5%. Second level exams are only recommended in the case of persistent microhaematuria and results should be considered in combination with medical history, clinical symptoms and erythrocyte morphology ...

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Society of Pediatric Nephrology – SINePe

In children presenting with a first episode of nephrotic syndrome, albumin infusions (followed by intravenous boluses of furosemide) should be exclusively limited to hypovolemic patients. While in these children albumin infusions can increase intravascular volume, thus improving renal haemodynamics and increasing diuresis, in hypervolemic cases the opposite occurs and hypovolemia can be exacerbated, contributing to hypertension and the risk of causing or worsening pulmonary oedema. Clinical ...

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Society of Pediatric Nephrology-SINePe

Routine urine culture (once a month) is often performed as part of the follow-up of children with congenital nephro-urological malformations or as part of the standard screening tests for children in good clinical condition. In these cases, the finding of bacterial growth, even at high colony counts, is almost certainly due to contamination, given the difficulty involved in collecting a sterile specimen from a child, or the possible presence of asymptomatic bacteriuria, which does not require ...

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Society of Pediatric Nephrology – SINePe

In paediatric clinical practice, the occasional finding of low-grade proteinuria is frequent, though it is not always an indication of kidney damage or disease. However, the definition of a more appropriate diagnostic approach is useful both for the timely detection of diseases which could potentially compromise renal function if neglected or left unrecognised, and in order to avoid useless and costly treatments. When low-grade proteinuria is detected, a thorough medical history should be taken ...

Choosing Wisely Italy. Doing more does not mean doing better (Fare di più non significa fare meglio)

Italian Federation of Registered Nurses' Colleges – Pediatric Nursing Area

Often, to perform invasive procedures and/or to position devices, we resort to the physical restraint of the child, with insufficient explanation of what will happen, and without an appropriate analgesic coverage. Missing pain control and anxiety management generate rejection, crying, anguish, stress, non-compliance in the little patient and worry and anxiety in his/her parents. In addition to the well known conventional procedures, there are valid alternative methods, such as: comfortable ...