Renal diseases in children present with a wide spectrum of clinical manifestations, ranging from mild urinary abnormalities to severe acute kidney injury requiring urgent management. Early recognition in the emergency setting is essential to improve outcomes, yet data on pediatric renal emergencies in Upper Egypt remain limited.

This prospective cohort study aims to characterize the clinical presentations of renal diseases among children presenting to the emergency room at Sohag University Hospitals, determine the prevalence of specific renal conditions, and evaluate immediate management outcomes and short-term follow-up after discharge.

Inclusion Criteria:

• Children aged 1 month to 18 years. Presentation to the emergency room at Sohag University Hospitals with signs and/or symptoms suggestive of renal involvement (e.g., edema, hematuria, oliguria/anuria, flank pain, hypertension).

Patients with a known history of renal disease presenting with acute exacerbation.

Written informed consent obtained from parents or legal guardians.

Exclusion Criteria:

• Incomplete or missing essential clinical, laboratory, or imaging data. Refusal or inability to obtain written informed consent from parents or legal guardians.

Patients with suspected renal symptoms later confirmed to have non-renal causes.

Patients who received renal replacement therapy prior to presentation at another facility.

The study population will include children aged 1 month to 18 years presenting to the emergency room of Sohag University Hospitals with clinical features suggestive of renal involvement. This includes both previously healthy children with new-onset symptoms and those with known renal diseases presenting with acute exacerbations. Patients will undergo routine clinical evaluation, laboratory investigations, and imaging as part of standard care, and will be followed during their hospital stay and after discharge.