Renal failure is a serious abnormality in the functioning of paired organs. In this condition, the kidneys lose their ability to ensure the normal exchange of fluids in the body. Symptoms of renal failure in a child are usually characterized by a whole complex of pathological changes that appear due to a partial or complete inability of the organs to do their job.
brief information
Most often, this pathology is diagnosed in adults, and only occasionally defect affects the children's body. Usually the disease is acquired, although there are genetic factors that contribute to its occurrence.
The primary symptom of renal failure in a child is a decrease in the usual volume of urine or its complete absence.
The baby's body can not work with the constant accumulation of harmful toxins and waste remaining after metabolism. In addition, he is unable to maintain a normal acid-base and water-salt balance. That is why the defect requires immediate medical attention, otherwise the risk of death increases at times.
Common signs of renal failure in children
The following clinical manifestations should become a cause for alarm and visiting a doctor:
- decreased urine output;
- clear swelling on the limbs and face;
- fever;
- yellowness of integument;
- various disorders similar to poisoning - fatigue, weakness, vomiting, lethargy, diarrhea, headache.
This is what the main symptoms of kidney failure in a child look like. Having identified such signs in a baby, immediately consult a specialist.
When conducting appropriate diagnostics, the doctor can detect pathological changes in the results of the tests, namely:
- proteinuria - the presence of proteins in the urine;
- calculi or sand in urine - symptoms of urolithiasis at different stages.
The appearance of nephrotic syndrome, which is characterized by an increased amount of protein in urine and a decrease in blood flow, as well as severe swelling, is a characteristic symptom of renal failure in children, but almost never occurs in adults.
Acute form of pathology
Acute renal failure in children is a syndrome that most recently most often ended in death. Today the situation is different. There are effective methods of treatment that make it possible to reduce the number of negative consequences at times.
According to statistics, acute renal failure is detected in about three children per million people. About a third of all patients are babies. Dialysis is prescribed for one of 5 thousand newborn babies. At the age of 1-5 years, this pathology is diagnosed in 4-5 children out of 100 thousand.
The acute form of insufficiency is accompanied by severe intoxication of the body with metabolic products that are not excreted in the urine due to renal dysfunction.
Symptoms of this type of defect develop rather quickly. Over the course of several years, the child develops symptoms similar to the manifestations of poisoning - the baby becomes lethargic, he is often sick, and sometimes vomiting is observed. These symptoms of renal failure in children are caused by intoxication with nitrogen metabolites and impaired water-electrolyte balance.
Parents should keep in mind that self-medication of this form of pathology is simply unacceptable. Choosing this path, you can only aggravate the situation and worsen the general condition of the baby, but certainly not help him.
After a while, the symptoms of renal failure in a child change. Previously, minimal diuresis increases again, while a baby may lose weight. Then comes the phase that doctors call clinical recovery. During this period, all signs of intoxication almost completely disappear in the child.
But do not rejoice and relax. After all, then the baby will have another relapse - the pathological manifestations return again. Any symptoms of renal failure in children under one year of age and older require immediate medical attention and urgent hospitalization.
Chronic form of the disease
This kind of pathology can appear as a result of an acute course, and also be a consequence of infection of the urinary canals and organs. Often the cause of renal failure in children is a complicated genetic factor.
Abnormal changes occur over a long period and can lead to a complete loss of kidney function.
Doctors conditionally subdivide the course of the disease into several stages:
- latent - not accompanied by severe signs;
- azotemic - a phase which is characterized by symptoms of intoxication and manifestations of other disorders, for example, in the digestive tract or cardiovascular system;
- decompensation - local inflammation and swelling are added to everything else;
- terminal - at such a phase, the only thing that can save a baby is hemodialysis or a healthy kidney transplant.
If the baby has minor disturbances in the activity of the kidneys or the excretory process, it is urgent to contact a pediatrician. If he finds any deviations, he will give direction to narrow specialists.
Pathogenesis
Kidney damage is primarily caused by hypoxia, which accompanies asphyxiation at the intrapartum stage. It is this condition that leads to abnormal neuroendocrine changes - an increase in renin production, hyperaldosteronism, an increase in the concentration of antidiuretic hormone in the blood. These changes, in turn, entail impaired renal perfusion. The condition of the child is exacerbated by metabolic acidosis and DIC, which are constant companions of hypoxia.
As a result of all these deviations, oligoanuria appears with characteristic metabolic failures. Gradually, the covers of the renal canals die off, which is accompanied by severe edema of the kidney and the development of anuria. With vascular thrombosis, which occurs due to the introduction of hypertonic solutions into the umbilical cord channels, as well as against the background of a strong and fairly rapid weight loss, the entire kidney can die.
Reasons for the appearance
Despite a significant increase in the number of newborns with urological pathologies, the development of renal failure is still a rarity. Usually, a similar pathology occurs in such abnormal conditions:
- complicated bilateral obstructive uropathy, regardless of the type of defect;
- dysplasia of kidney tissue, most often sonographically detected cysts;
- hypoplasia together with renal tissue dysplasia;
- severe inflammatory diseases - bilateral ureteritis, pyelonephritis, cystitis;
- unilateral pathological changes described above, in the absence of a second kidney or its dysfunction.
In newborn babies, renal failure may have a medicinal origin, which is associated with the use of radiopaque agents and aminoglycosides. The effects of these drugs damage the glomerular system of the kidneys.
Diagnostics
First of all, at the appointment, the doctor will collect all the necessary medical history from the words of the parents and the child himself, after which he will carefully examine the small patient to identify visual signs of kidney failure. Then, without fail, the baby is given a referral to general urine and blood tests.
As auxiliary methods, instrumental examinations can be used:
- ultrasonography;
- ureteroscopy;
- cystoscopy.
In some cases, an additional biopsy of the affected kidney is performed.
In the diagnosis of renal failure in children, it is very important to detect a decrease in diuresis, azotemia and impaired VEO. In addition, doctors with this pathology always detect abnormal changes in urine, for example, a reduced concentration of creatinine and urea.
Among other things, this defect should be differentiated from functional renal failure. For this, stress tests are used:
- with vasodilator drugs;
- with saluretics;
- with alkalinization of urine and water load.
Clinical recommendations for renal failure in children
In the treatment of the acute form of pathology, the main procedures are those aimed at cleansing the body of toxins accumulated in it and stabilizing full circulation in the tissues of organs. For this purpose, drugs of various categories are used: diuretics, vasodilators, anti-shock medicines, as well as drugs to reduce blood viscosity.
Clinical recommendations for chronic renal failure in children up to a year, as a rule, come down to the appointment of hemodialysis. The use of a special device for filtering blood - a synthetic kidney - will stop a variety of complications, including swelling of the brain and lung tissues, high blood sugar, and too high blood pressure.
Children over 10 years old are often recommended to attend plasmapheresis sessions. These procedures allow you to cleanse the blood outside the body.
In chronic renal failure in children, clinical recommendations often involve the use of antibacterial drugs (Levofloxacin, Pefloxacin, Ciprofloxacin, Cephalotin, Ampicillin). This is necessary to reduce the risk of secondary infection, as well as to eliminate the existing infection. The use of glucose, potassium and electrolyte drugs acts as a supportive therapy.
Keep in mind that chronic renal failure in children requires complex treatment, moreover, not only the affected kidney, but also concomitant defects.
Drug therapy
If the baby has signs of the second or later stages of the pathology in the form of intoxication, then hemodialysis sessions are mandatory. As for medicines, the following are most often used:
- Antacids. They play the role of symptomatic therapy. This is sodium bicarbonate, Andrews Antacid, Bourget, Inalan, Tams, Rennie.
- Mineral and vitamin supplements - calcium, B vitamins, vitamin D. These are Alphabet, Pikovit, Vitrum Baby, Multi-Tabs, Univit Kids.
- Iron-containing drugs if anemia develops. Hemoferon, Kheferol, Venofer are appointed.
- Medicines aimed at lowering the concentration of phosphorus in the body. This is calcium carbonate, calcium citrate.
- Diuretics. They are necessary to stabilize the process of urine excretion. Often prescribed "Hypothiazide", "Diacarb", "Veroshpiron", "Furosemide."
- Antihypertensive drugs - with concomitant hypertension. This is Concor, Atenolol.
If we are talking about the late stage of chronic renal failure in children, as well as about the too severe course of the disease, the only treatment option may be a transplant of a healthy donor kidney.
Alternative recipes to eliminate symptoms
Of course, the treatment of renal failure in children with alternative means is out of the question. But in combination with physiotherapeutic procedures and drug therapy, alternative agents can be used to relieve some symptoms and alleviate the general condition of the baby.
- Restorative drink. Mix in equal proportions raspberry branches, mashed rosehip berries and chopped blackcurrant leaves. A tablespoon of the resulting mixture pour 0.5 liters of boiling water. Every day, give the child half a cup of the prepared drink.
- Pomegranate juice. Of course, if possible, the baby should be given just a freshly squeezed drink. Pomegranate juice helps to stabilize the disturbed water-salt balance. It is advisable for the baby to give a drink in a diluted form, adding a little warm water to it. The systematic use of this drink for two months will help strengthen the whole body.
- Rosehip and pomegranate decoction. Grind the berries and pomegranate peel, combine the ingredients in equal proportions. Then pour boiling water over the mixture and cook for 5 minutes. Let the broth cool and strain through a fine sieve or cheesecloth. You can speed up the manufacturing process of the product by letting it infuse in a thermos instead of boiling. The prepared broth should be given to the child throughout the day in small portions.
Conclusion
Renal failure and other malfunctions in the work of this body are not in vain considered a very serious and dangerous violation, which can lead to death or the need for transplantation. That is why you should not ignore the symptoms of pathology that systematically appear in the child.
Do not forget that a timely visit to a doctor can provide the correct diagnosis and, accordingly, treatment. In addition, only with this approach can we count on minimal complications of the disease for the child's body.
No less important is the observance of all medical instructions in the treatment of various infections in the baby's body. After all, it is precisely such diseases that often lead to the development of dangerous renal failure.
But even if hemodialysis has been prescribed for your baby, don’t panic. Indeed, according to statistics, most cases of treatment of acute and chronic renal failure had a successful outcome. Only one thing is important - strictly follow all the instructions of a specialist.