Treatment of glomerulonephritis in children

The kidneys contain many small coils of blood vessels, called glomeruli, that filter waste products from the blood into the urine. Glomerulonephritis is a form of kidney disease that makes it difficult for the kidneys to function properly. Glomerulonephritis in children is common after streptococcal pharyngitis.

Glomerulonephritis in children can be caused by diseases such as:
Systemic autoimmune disease: The body's immune system mistakenly attacks healthy cells, causing many parts of the body to be affected ( eg systemic lupus erythematosus ); Polyarteritis: An inflammation of many small and medium arteries throughout the body; Granulomatosis: A progressive disease that causes inflammation to spread across all organs of the body; Henoch-Schönlein purpura: Creates large or small purple purpura on the skin and internal organs. The disease also causes other symptoms in some organs; Alport syndrome: An inherited form of glomerulonephritis that affects both boys and girls. However, men are more prone to kidney problems; Streptococcal infection : Acute glomerulonephritis in children usually occurs after at least 1 week of recovery from strep throat or upper respiratory tract infection; Hepatitis B : Can be passed from mother to child or transmitted by blood transfusion (more rarely). Children with these conditions have a higher risk of developing glomerulonephritis.

The doctor will ask about the symptoms and medical history of the child and family members. The child will then have a physical examination and tests such as :
Nasopharyngeal culture : This is done to check for strep throat . The doctor will use a swab and gently wipe the child's throat to collect bacteria; Blood tests: Helps evaluate blood cell counts, electrolyte levels and kidney function; Urinalysis: Look for protein and blood in the urine, as well as other problems; Electrocardiogram (ECG): Recording the activity of the heart, showing irregular heartbeat and detecting damage to the heart muscle; Kidney ultrasound: Uses sound waves and a computer to take pictures of body tissues. Through a transducer on the abdomen in the kidney area, the doctor can see the size and shape of the kidney, as well as the growth of stones, cysts, or other problems (if any); Chest X-ray: Uses a small amount of radiation to make pictures of tissues, bones, and organs on film; Kidney biopsy: A small sample of kidney tissue is removed with a specialized needle or during surgery, and then examined under a microscope.

3.1. Principles of Treatment Most children with kidney disease will be monitored by a pediatrician who specializes in kidney disease. The treatment regimen for acute glomerulonephritis in children will be indicated based on:
Age, overall health and medical history of the child; Severity and prognosis of the disease; The underlying cause of the disease; The child's tolerance to specific medications or therapies; Parents' opinions or expectations. Treatment for acute glomerulonephritis in children focuses on slowing the progression of the disease and preventing complications. If pediatric acute glomerulonephritis is caused by a streptococcal infection, treatment is primarily with antibiotics to treat the infection and control associated symptoms.
3.2. Dietary Changes As part of the treatment of acute glomerulonephritis in children, pediatric patients may need to limit:
Protein: Protein is an essential nutrient that is important for proper growth . However, the kidneys cannot remove all the waste products if the person eats too much protein. The doctor will suggest the specific amount of protein your child is allowed to eat during the day; Potassium: Although an important nutrient, when the kidneys are not working properly, excess potassium accumulates in the blood. Minerals are found in some foods high in potassium, and children with the disease may need to limit or avoid them; Phosphorus: The kidneys are responsible for removing excess phosphorus from the body. If the glomeruli become inflamed, too much phosphorus builds up in the blood and can cause the bones to lose calcium. This makes the child's bones weaker and more fragile, so it is necessary to limit phosphorus-rich foods; Sodium: A low-sodium diet helps prevent or reduce water retention in the body. The doctor will specify the amount of sodium allowed in the child's diet. 3.3. Medications Some medications used to treat acute glomerulonephritis in children may include:
Diuretics; Medicines to lower blood pressure; Immunosuppressive drugs; Phosphate binder to reduce the amount of mineral phosphorus in the blood.

3.4. Dialysis In some cases, pediatric patients can have serious problems with electrolytes, which increases waste products in the blood to dangerous levels. If your child has fluid overload, hemodialysis may be needed to remove waste and excess fluid, a function normally performed by the kidneys. There are 2 types of dialysis:
Peritoneal dialysis, also known as peritoneal dialysis This method filters blood through the lining of the abdominal cavity and can be done at home. The abdominal cavity is the space that contains organs such as the stomach, intestines, and liver. The lining is called the peritoneum.
First, the surgeon places a thin catheter into the child's abdomen. Then dialyze the sterile cleaning fluid through the catheter into the peritoneal cavity. Fluid stays in the abdomen for a while to absorb waste products through the peritoneum. Finally, the fluid is drained from the abdomen and removed. This process of pumping and draining the fluid is called exchange.
Hemodialysis Performed in a dialysis center or hospital. A special device that connects arteries and veins together, called an arteriovenous (AV) fistula, is placed into the patient's arm through minor surgery. An external IV (intravenous) catheter may also be inserted, but is less common in cases of long-term dialysis.
The patient will then be connected to a large hemodialysis machine. Blood is drawn from a tube and fed into a machine to filter waste and excess fluid. The filtered blood then flows through another tube back into the body.
Hemodialysis is usually done several times a week for 4-5 hours each time. Parents can bring toys or read stories to their children during this process.
Overall, treatment for acute glomerulonephritis in children will depend on the underlying cause, which may include fluid restriction, dietary changes, certain medications, or dialysis. Parents should talk with their doctor about the possible risks, benefits, and side effects of all treatments for acute glomerulonephritis in children.
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Reference source: chop.edu; stanfordchildrens.org

SEE ALSO:
Complications of acute glomerulonephritis in children Treatment of acute glomerulonephritis in children How to care for and prevent acute glomerulonephritis in children