Pediatric Nephrology Case Study
Overview
Pediatric/Child Nephrology
Pediatric nephrology is a subspecialty of pediatrics focussed on providing expert care in diagnosis and treatment of children suffering from acute and chronic kidney diseases. These include solitary kidney, ectopic kidney, hydronephrosis, nephrotic syndrome, glomerulonephritis, hemolytic uremic syndrome, hypertension, urinary tract infections, vesicoureteral reflux, renal tubular disorders, kidney stone, acute and chronic renal failure.
Procedures done at our Centre:
1. Renal Biopsy
2. Acute and Chronic Peritoneal dialysis
3. Hemodialysis
4. Plasmapheresis
Presentation of a child with kidney disease
Kidney disease in children often remain undiagnosed due to non specific signs and symptoms. The tell
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Early morning puffiness around eyes after a upper respiratory tract infection
2. Swelling of face, belly and feet.
3. Decreased urine output
How is it diagnosed?
Blood tests reveal low albumin, high triglycerides and cholesterol and urine tests reveal massive proteinuria
Is the disease treatable?
Of course. Steroids are given for 3 months to treat first episode of nephrotic syndrome. 80% patients respond to steroids. 20% do not respond and are steroid resistant in whom alternative medications are given.
Steroids? Aren’t They harmful?
No drug is free of side effects which need to be monitored. Steroids is the only drug that can reduce puffiness and stop the urinary leak of proteins effectively and side effects like increased appetite and weight gain are temporary. Other side effects like short stature, cataracts and hypertension are seen with longer duration of steroids.
Does the disease recur?
Most children with nephrotic syndrome respond well to steroid treatment. The protein disappears in the urine and then the swelling reduces within a week or two. Some children however may take longer time to attain remission. The treatment is continued for 3 months. However 50- 60 % patients have recurrence of swelling which is termed
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