NEPHROTIC SYNDROME IN KIDS
Nephrotic syndromein kids is characterized by generalized edema, proteinuria, hypoproteinemia, hyperlipidemia.
Causes of Nephrotic Syndrome in kids
1. Idiopathic: Common in children
2. Systemic Lupus Erythematosus
3. Congenital syphilis: In infants
4. Amyloidosis: Rare
5. Malaria: Rare
Types of Glomerular Lesions
1. Minimal Lesion form of Ne- phrotic Syndrome
In childhood. 75% nephrotic syn- dromes are of this variety. They respond well to steroid therapy. On light microscopic examination of kidney tissue, no significant chang- es are seen. However, on electron microscopic examination there is extensive fusion of epithelial cell foot processes. There is no deposi- tion of glomerular immunoglobulin or complement.
2. Focal Glomerulosclerosis
Segmental scarring of some of the glomeruli, mainly of the Juxta- Medullary region. Hematuria may be present along with other features of nephrotic syndrome. Renal Biopsy may be normal if it doesn’t contain scarred segmental portion, if biopsy is from scarred segment. It will show sclerosed glomeruli. There is deposition of Immunoglobulin M (IgM). These patients may be steroid resistant and may develop chronic renal failure, progressing to end stage renal disease.
3. Membranous Glomerulonephritis
On light microscopic examination, it shows thickening of glomerular basement membrane without any inflammatory changes in glomeru- lus. There is deposition of immuno- globulin G (IgG). It is seen in late childhood and patient may require prolonged steroid therapy. It is a rare condition.
4. Membranoproliferative Glo- merulonephritis
On light microscopic examination of renal biopsy tissue, it shows enlarged glomeruli, and there is thíckening of capillary walls and proliferation of mesangial cells. There is deposition of immunoglob- ulin and compliment. It is further divided into type I and type II depending upon the site of depo- sitions. Clinical picture may be of mixed nephrotic pattern- Protein- uria with hematuria. Response to corticosteroid therapy is poor and chronic renal failure is common.
Minimal Lesion form of Nephrotic Syndrome –
Onset of the disease is insidious. It is more common between the age of 2 and 7 years.
CLINICAL FEATURES SYMPTOMS OF NEPHROTIC SYNDROME IN KIDS
1. Edema: First noticed around the eyes. More during morning hours after getting up from sleep. In advanced stage, it may be associated with puffiness of face, edema of feet and distension of abdomen due to ascites and sacral edema.
2. Oliguria: May go unnoticed or, mother may notice decrease in the frequency of urine.
3. It may be associated with symptoms of upper respiratory tract.
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SIGNS OF NEPHROTIC SYNDROME IN KIDS
1. Puffiness of face
2. Pitting edema on dorsum of foot and shin
3. Sacral edema
4. In advance cases, signs of ascites may be present viz- Transversely stretched umbilicus with shifting dullness.
5. Blood pressure is normal.
6. There may be hepatomegaly in some cases.
COMPLICATIONS OF NEPHROTIC SYNDROME IN KIDS
1. Relapse of the disease
3.Severe ascites causing respiratory distress .
4.Shock: Due to injudicious use or diuretics
5. Increased susceptibility to bacterial infection mainly upper respiratory
NOTE-Do not follow any (TOPIC:CONVULSIONS IN KIDS) treatment And medicine provided here ,please consult nearest hospital and talk to your doctor.This artical is only for knowledge purpose,consult your pediatric doctor for better support and follow the doctors medicine and WHO(WORLD HEALTH ORGANISATION) guide line for pediatric cases and about child health.
MOTHER CAN NOTE DOWN CHILD,S ROUTINE IN DIARY, TO HELP DOCTOR FOR BETTER TREATMENT AND UNDERSTANDING THE CHILDS PHYSIOLOGY AND ROUTINE ,SO THEY CAN PROVIDE BETTER TREATMENT AND USE BETTER MEDICINE FOR THAT CASE .
Ayurvedic medicine and way of treatment can also be helpfull as you have to consult pediatric doctor(BALROG CHIKITSK)
Thank you for reading this article