Acute renal failure in a child (ARF) is a serious problem that parents are faced with. Depending on the severity of the condition, it can provoke a violation of all body functions, which leads to a severe disorder of homeostasis.
Therefore, it is so important to identify this alarming pathology at the initial stage. To do this, you need to learn a little more about this clinical condition and clarify what are the symptoms of acute renal failure in a child. Let's consider them in more detail.
Why does the disease develop?
If we talk about the factors that lead to such a pathology, then there can be many. Some causes of acute renal failure in children cannot be bypassed through preventative measures. Therefore, timely detection of the first symptoms of this ailment remains.
For example, if we are talking about newborn children, then various abnormalities in the development of the heart apparatus, lack of kidneys, and congenital vascular pathology can be attributed to similar factors. ARF can cause a blood clot to enter the renal vein or impaired urinary tract patency. An infection could get into the baby’s blood. This leads to quite severe sepsis.
Infants are also subject to severe dehydration. It can occur due to an infectious disease from which the baby began to suffer, while still in the womb. Sometimes this happens due to injuries and other injuries in the process of labor itself.
If we talk about the causes of acute renal failure in a child aged from one year to 3 years, then in this case other factors that can provoke a similar condition come first. Of course, do not exclude anomalies and congenital ailments. However, in addition to them, children at this age often suffer from kidney infections, complex pathologies that occur in the intestines and severe metabolic disorders.
If we are talking about older children, aged 3 to 14 years, then in this situation, doctors most often diagnose acute renal failure in a child against the background of poisoning with potent chemicals or drugs. A severe infection, injuries and situations that cause an acute reaction of the body can lead to acute renal failure. For example, a burn or severe bleeding can provoke such an ailment.
Regardless of age, acute renal failure in a child manifests itself in a certain sequence. Therefore, it will be useful to find out how an unpleasant pathology proceeds.
Stages of the development of the disease
There are several stages of the manifestation of pathology. Consider the main stages.
- Initial. In this case, the possible symptoms will depend on the specific cause of the ailment. Renal failure alone does not manifest itself. In some situations, parents note a decrease in the volume of urine in the child. However, this does not always happen. The first stage lasts relatively shortly, from 6 to 24 hours.
- Oligoanuric. This stage is characterized by more pronounced signs of acute renal failure in children. This is due to the fact that internal organs gradually begin to be affected. It should be alerted that the child began to suffer from wheezing in the lungs, low pressure (although this had never happened before), problems with the intestines, a very sharp decrease in fluid volume during urination. This stage lasts from a day to several weeks. During this time, the doctor must identify the exact cause of the alarming symptoms and prescribe the best treatment for acute renal failure in children.
- Recovery. If parents and the doctor took measures in a timely manner, then adequate treatment will help the baby get rid of the disease. He will begin the recovery phase. During this period, the urinary system starts working again as it should, all body functions return to normal. As a rule, this stage takes from 5 days to two weeks.
- Recovery. The child ceases to experience any unpleasant symptoms. However, you need to understand that a full recovery is possible not earlier than in a year. Since renal function was impaired, it will take quite a while for the body to return everything to its previous state.
Speaking of acute renal failure in a child, it is worth noting that in this case, recovery is easier than in an adult. This is because the young body is able to regenerate affected cells at a faster rate. Therefore, most often this disease does not pose a danger. But only on condition that treatment began on time.
Otherwise, the pathology will go into the chronic stage, and it will be very difficult to get rid of it.
Acute renal failure in a child: symptoms of the disease
Standard signs of pathology, as a rule, most noticeably begin to appear closer to the beginning of the second stage. Therefore, it is worth learning more about them. For example, you should consult a doctor if the child began to gain weight too quickly. Moreover, weight gain occurs mainly due to swelling. At the same time, there will be a decrease in urine during trips to the toilet.
Also, blanching of the skin is referred to the symptoms of acute renal failure in children. In this case, the child will constantly itch and complain of severe itching. Additionally, it is worth checking the breath of the child. If it is fetid, then this is also a rather serious sign of the development of the described pathology.
As with many other ailments, the baby will sleep poorly and eat. It is worth noting the appearance of his weakness. Interest in active games disappears. The child gets tired too quickly.
Also, evidence of developing acute and chronic renal failure in children can be the appearance of dry mouth, nausea, vomiting, and diarrhea. It is also worth checking the pressure readings of the child. If it is lowered, and the pulse is too slow, then this is also one of the symptoms of an acute renal failure.
If the child is already talking, then he may begin to complain of shortness of breath, pain in the chest or abdomen. Such a clinical picture indicates that it is necessary to immediately diagnose acute renal failure in a child. Only then can treatment begin.
Diagnostic measures
This is a necessary stage. Regardless of the cause of acute renal failure in a child, the diagnosis will help to understand what exactly the doctor has to fight with. As a rule, such events are complex. This means that, first of all, an inspection is necessarily carried out, and then the necessary laboratory tests are carried out. First of all, the doctor tries to identify the causes of the disease during the conversation. Moreover, he should be guided by the protocol of acute renal failure in children under the number P-P-023. It describes the stages of the disease and its manifestations. Based on this, an initial inspection and survey is carried out.
After this, the small patient is sent for laboratory tests. To do this, you need to take a blood sample, urine and feces of the child. This will help determine which infections the patient may be suffering from. Further, adhering to the protocol of acute renal failure in children, specialists carry out a number of other procedures.
Visual diagnosis
At this stage, it is important to see the full picture of the state of the child’s kidneys. To do this, first of all, an ultrasound, CT or MRI scan is performed, an x-ray is taken. The doctor determines if there are any stones in the kidneys.
If there is a theory that acute insufficiency developed against a blockage by a blood clot, then more detailed analyzes will be required. For this, numerous tests are carried out.
First of all, it is necessary to study the anatomy of the kidneys of a particular patient. For this, a tube with a small bulb should be inserted into his urethra. It is necessary in order to install a catheter through which a special dye fluid will go. It is necessary in order to make a high-definition x-ray.
An MRI is also required, as this test method is considered more reliable. The physician must understand if structural changes have occurred. If they affect the urinary tract, then in this case, more strong magnetic radiation will be concentrated around the abdomen.
Only after all these measures will it be possible to begin immediate therapeutic measures.
Additional activities
It is very important to evaluate kidney function. Therefore, biochemistry of blood is mandatory. Additionally, you need to clarify the indicators of urea, protein, sodium and other components. For this, the urine of a small patient is studied.
If serious changes have been identified, then in this case the tests are re-submitted after a few days. But the level of urea will need to be determined daily. Based on the data obtained, you can create a graph that will help to clarify the features of the condition of a small patient.
Also, an ultrasound scan and a number of additional mandatory tests are required daily. However, such events are most often required if it is a newborn baby. The first days of life may turn out to be critical, so specialists should receive data in almost real time.
Treatment features
When it comes to acute renal failure in children, clinical recommendations must be followed scrupulously. Especially with the development of pathology in very tiny babies. As a rule, in such situations, babies are placed in special cells - couves. They maintain a constant and optimal temperature regime. In this case, every few hours, the specialist must turn the baby so that he is not in the same position. At such a young age, this is fraught with the development of rhabdomyosis. It is also recommended several times a day to conduct massage sessions.
It is important to constantly monitor the state of the heart and respiratory rate. Blood pressure checked. Doctors also monitor any changes in the patient’s body temperature. Urine is collected every hour. Weighing is also required at least once every 12 hours. This will help to understand if he is gaining mass.
Treatment at the second stage of the development of pathology
If the initial stage of the development of pathology has already passed, then in this case a number of measures are required that will help ease the condition of the baby. First of all, it is necessary to correct the so-called volemic disturbances. For this, a weak glucose solution or saline solution is used. The infusion is administered over a period of 30-60 minutes. Also, the doctor may prescribe albumin, infucol and other drugs.
If no effect is observed, then in this case the course of glucose administration is repeated. It can be replaced with 0.9 percent saline. In this case, the dosage of the composition is calculated depending on additional factors. For example, premature infants receive less fluid than newborns who were born on time.
Also, in the process of treatment, it is necessary to improve renal blood flow. To do this, dopamine or a 4 percent dopamine solution is usually prescribed.
If a decrease in myocardial contractions was diagnosed, then drugs of the cardiotonic group will be required.
Acute renal failure in children: clinical recommendations for prevention
If we talk about activities of this type, first of all, parents should do everything possible to completely eliminate risk factors. For example, acute renal failure can occur against the background of numerous serious diseases that were not diagnosed in time in the child. In order to avoid unpleasant consequences, it is recommended to undergo a full examination annually and be sure to show the baby to the therapist.
If we are talking about children who have already encountered an ailment, then you need to monitor the water balance of the small patient, especially if he is in hospital treatment.
If we talk about the recommendations that are intended for the doctors themselves, then in this case, experienced specialists advise very carefully approach the appointment of any drug. In some situations, you can get by with a diet that implies a low protein content. If there is a real danger that liver failure will occur, then in this case the so-called shock therapy is used as a prophylaxis. However, in this case we are not talking about extreme bullying of people, but about the fact that a special solution is introduced into the bloodstream that helps the body recover. Also, fluid components help prevent the development of further pathology.
If we talk about acute renal failure in a child, the prevention of the disease implies primarily the care of the baby who has had this disease. First of all, actions should be aimed at restoring the volume of fluid and blood. For this, transfusions are usually used. It is also equally important to completely restore the lack of interstitial tissue fluid. Additionally, kidney drainage is performed. To do this, they are filled with a special solution.
Along with therapy, so-called asthmatic drugs can be used. These include Reopoliglyukin, Gelatin and others. They are introduced in a volume of up to one and a half liters. However, in no case should these values ​​be exceeded. Otherwise, osmotic nephrosis can be caused. If we talk about medical preventive measures, then a large role is given to osmotic diuretics.
There are also recommendations for parents. First of all, in no case can you experiment with certain medicines. Acute renal failure is a very serious pathology, so the treatment of the disease is carried out exclusively by specialists. If we are talking about that child who has a predisposition to such a disease, then it is extremely difficult to avoid it. However, regardless of this, it will be useful to maintain the baby's immune system at the proper level. It is better to spend as much free time as possible in the fresh air and carefully check the child’s diet. It should not contain chemical additives or other components that are not recommended for use.
Chronic renal failure in a child
In this case, we are talking about a nonspecific syndrome that can occur against a background of impaired renal function. It is easy to guess that pathology goes into the chronic stage if it progresses, and no treatment is provided. There are many classifications of chronic failure. Only a specialist can determine it more accurately.
If we talk about the reasons for the development of this form of pathology, then in this case, you need to pay attention to several factors. For example, it is likely that before this, the child's kidney function decreased to a small extent. Also, this can occur against the background of progressive nephropathies. There is an increase in instability of the cell membrane. In rare situations, acute and chronic renal failure in children can occur while taking potent drugs. In addition, there is a certain group of children who are more susceptible to such an ailment.
For example, parents of those children who suffer from severe uropathy should be especially careful about the health of babies. Also at risk are children with hereditary nephritis. It can be expressed in a variety of forms. These may be congenital or acquired diseases.
If we talk about the manifestations of chronic renal failure, then in the first place there are changes in the renal parenchyma. Later, the number of nephrons that are able to function is significantly reduced. Gradually affected cells begin to be replaced by connective tissue. At the first stages of the disease, normal cells begin to perform the function of the affected nephrons. However, such a compensatory function is not able to act for a long time. With urine, metabolic products cease to be excreted to a normal degree. Instead, they linger in the body. And this, in turn, leads to serious damage to tissues and organs. If the water balance is disturbed, then this only exacerbates the situation.
If we talk about the initial stage of chronic renal failure, then in this case, in children, on the contrary, the volume of urination first increases, and then sharply decreases. If even in this case no treatment is followed, then a stage may occur in which urine will not form at all. It is easy to guess that this can lead to the worst consequences. Therefore, do not delay until the last, it is better to immediately carry out treatment. The child’s body, especially in the first years of life, is only being formed and is not able to fully resist all possible failures. Therefore, prevention, inspection and, if necessary, diagnostic measures should be carried out regularly.