Most adult health problems have a prerequisite for development in childhood. This also applies to diseases of the urinary system. Urolithiasis, or kidney stones, is most often the result of metabolic nephropathy. In children, various variants of the course of pathology occur at different ages. To prevent the development of complications in the future, it is important to correct metabolic disorders immediately after their detection.
Medical certificate
The kidneys are the main element of the body responsible for cleansing the blood of harmful substances. This process is well thought out by nature at all its stages. The baby's kidneys begin to function long before his birth. Even in the womb, they are responsible for cleaning the blood from metabolic products. Filtration is carried out thanks to the renal glomeruli and a system of special tubes - tubules. In the latter, blood is divided: useful elements are sent back through the bloodstream, and unnecessary is excreted along with urine. The process itself is continuously monitored by the endocrine glands.
Metabolic nephropathy in children is a clinical symptom complex, and not a separate disease. Various pathologies can lead to its development. However, the elimination of the root causes allows you to forever forget about the insidious disease, lead a familiar lifestyle. The lack of timely diagnosis and proper treatment is dangerous for the occurrence of renal dysfunction and nephrotic syndrome. The latter is accompanied by severe edema in the face and upper body.
Main reasons
The main cause of the pathological process is considered to be metabolic disorders. Such changes lead to the appearance of various salt crystals in the urine of the child, the development of inflammation.
In addition, a whole group of factors can provoke a violation in the work of the kidneys. Among them, the most common are the following:
- intoxication with chemicals;
- malnutrition;
- poisoning by industrial products;
- anatomical abnormalities that appear after the birth of a child.
Separately, an inborn form of pathology should be considered. In this case, renal dysfunction is detected already in the first few months after the appearance of the baby. Its main cause is the complicated course of pregnancy. If during the period of gestation the future mother has gestosis in the 3rd trimester, the likelihood of developing renal metabolic nephropathy in the child increases several times.
Various conditions accompanied by fetal hypoxia can also provoke a congenital pathology. Oxygen starvation of the fetus in the initial stages of pregnancy leads to a disorder of organogenesis. At the same time, the bookmark and intrauterine development of the kidneys fail.
Some mutations at the genetic level can also trigger nephropathy. However, such cases are extremely rare in medical practice.
Pathology classification
Depending on the underlying cause, metabolic nephropathy in children may be primary or secondary. Primary primarily occurs in infants and is a hereditary abnormality. This form of pathology is progressing rapidly. Against its background, kidney failure or urolithiasis usually develops.
Secondary nephropathy is diagnosed more often. It develops against the background of exposure to endogenous and exogenous factors. The bulk of such nephropathies is a violation of calcium metabolism. Normal in the analysis of urine is a certain amount of salts in dissolved form. Under the influence of negative factors, they crystallize and precipitate into a characteristic precipitate.
There is also another classification. Depending on the crystals of salts prevailing in urine, the following types of metabolic nephropathy in children are distinguished: oxaluria, phosphaturia, uraturia, and cystinosis. Each type of pathology has characteristic features.
- Oxaluria This type of pathology occurs in 80% of cases. Mostly hereditary. For a long time, oxaluria is asymptomatic. It appears closer to preschool age. In the analysis of urine, crystals of oxalates, protein, erythrocytes and leukocytes in small quantities are found. The course of the pathology has practically no effect on the development of the child. In some cases, symptoms characteristic of the VSD, allergic reactions are manifested.
- Uraturia. This is a rare pathology (up to 5% among all cases) due to impaired uric acid metabolism. In the early stages, it is not possible to diagnose it. Uraturia is characterized by a latent course. At first, urine analysis is not significantly different from normative indicators. As the disease progresses, the number of urates in it increases, urine itself acquires a brick hue.
- Phosphaturia. This kind of pathology is a violation of metabolic processes involving phosphorus and calcium. Its main cause of appearance are infections of the urinary system. Much less often, phosphaturia is formed against the background of an unbalanced diet or CNS pathologies, rickets. The insignificant presence of salt crystals in the urine is not considered a deviation, therefore, it does not require specific therapy. The level of phosphates can be adjusted through diet, taking "Kanefron."
- Cystinosis Pathology is characterized by an excessive content of cystine in the urine - the result of metabolic processes of an aliphatic amino acid. An excess of it in the cells and the impossibility of reverse absorption is a consequence of genetic abnormalities. The substance accumulates not only in the kidneys, but also affects the lymph nodes, liver and spleen.
Determining the type of metabolic nephropathy in children during a diagnostic examination allows you to choose the right treatment.
Clinical picture
Most forms of pathology are asymptomatic. At the same time, the child is practically not worried about anything; he is actively developing and growing. Disorders in the work of the kidneys are usually detected after passing a general urine test. Salt crystals that appear in urine always indicate problems with metabolic processes.
Only in some cases are there characteristic signs of metabolic nephropathy. For example, with congenital oxaluria, symptoms of gout, arthropathy, diabetes, or urolithiasis can occur. These are the so-called combined pathological conditions. They develop due to the initial metabolic disorder, and at various levels.
Children with kidney dysfunction often suffer from obesity, hypotension, and allergic manifestations. They may have problems urinating in the form of burning or soreness. We can say that the symptoms of metabolic nephropathy in children are very specific. They are largely due to the underlying disease.
Diagnostic Methods
At home, it is not possible to detect kidney dysfunction. Sometimes parents discover salt crystals when draining urine from a baby pot. Normally, urine has a straw color and is quite transparent. If cloudy impurities or sediment appear, consult a doctor.
Diagnostics and subsequent treatment of metabolic nephropathy (code for ICD-10 - N16.3) is carried out by a pediatric urologist or nephrologist. After a physical examination, examination of complaints, the specialist prescribes additional tests. They are necessary for making the correct diagnosis and clarifying the form of pathology.
Mandatory is a general urine test. It allows you to determine the presence of crystals, protein in it. Urinalysis according to Nechiporenko is recommended in complex cases. With its help, you can identify hidden forms of pyelonephritis and glomerulonephritis, which sometimes cause childhood nephropathy.
An ultrasound scan is also prescribed to evaluate kidney function and determine structural changes. This is an absolutely safe diagnostic method. Older children additionally require a review urography using a contrast medium.
Drug therapy
Clinical recommendations for metabolic nephropathy in children for treatment depend on the type of pathology.
For example, in the case of its oxalate form, preparations with an antioxidant effect and a membranotropic effect are prescribed. With uraturia, a good therapeutic effect is exerted by medicines that reduce the production of uric acid (Nicotinamide, Cystenal). To relieve phosphaturia, acidifying urine is prescribed (Methionine). In the case of cystinosis, Blemaren, citrate mixtures are recommended for alkalization of urine.
The choice of specific drugs, their dosage is determined by the doctor. Self-treatment is undesirable.
Features of diet
Treatment of metabolic nephropathy in children is impossible without following a special diet. As a rule, a cabbage-potato diet is recommended. However, depending on the form of the disease, some products are prohibited.
With oxalate nephropathy, the use of red meat, spinach, chocolate and sour berries is not recommended. In the case of uraturia, it is better to abandon beef and pork liver, legumes, cocoa and various types of nuts. If the doctor has diagnosed “phosphate nephropathy”, fatty cheeses, chicken, peas and chocolate should be excluded from the diet. With cystinosis, the list of prohibited foods includes cottage cheese, eggs, meat and fish.
We must not forget about the proper drinking regimen. To reduce the concentration of salts in the body, it is necessary to consume a sufficient amount of fluid. It is better to choose mineral or ordinary water without gases.
Physiotherapeutic treatment
Physiotherapy is recommended if there is a concomitant inflammatory process in the kidneys. We are talking about diseases such as pyelonephritis, interstitial nephritis. To stop inflammation, use the following procedures:
- Ultrasound therapy;
- magnetotherapy;
- mud therapy.
Help traditional medicine
As an auxiliary method of treating metabolic nephropathy in children, Dr. Komarovsky, who is a famous pediatrician, recommends alternative therapy. However, in this case, you can not do without a preliminary consultation with a doctor.
Herbal preparations of various compositions show high efficiency in the fight against various nephropathies. In order not to become addictive, medicinal plants must be changed every 2 weeks.
For example, oats are good for kidney dysfunction. Approximately 200 g of raw materials need to pour 2 liters of water, boil. Then the broth should be filtered. It is recommended to take the drug twice a day, while each time increasing the dosage from 1/3 to a whole glass.
Prognosis for recovery
If a small patient complies with all the recommendations of a doctor, he manages to quickly cope with the disease. The prognosis in most cases is favorable. The biochemical parameters of urine as treatment improves, severe symptoms recede.
Prevention Methods
To prevent metabolic nephropathy, it is necessary to undergo a full medical examination once a year. If the child is at high risk, he needs a special drinking regimen. In addition, it is important to exclude all factors provoking the disease, treat all diseases in a timely manner. Only in this case can we hope that the disease will pass by.