Introduction:
Introduction:
Understanding Pediatric Nephrology:
Significance of Pediatric Nephrology:
Common Conditions in Pediatric Nephrology:
Congenital Anomalies of the Kidney and Urinary Tract (CAKUT): CAKUT refers to a diverse group of structural abnormalities affecting the kidneys, ureters, bladder, and urethra in newborns. It can lead to urinary tract obstruction, vesicoureteral reflux (VUR), or renal dysplasia. Early detection and intervention are essential to preserve kidney function and prevent complications.
Acute and Chronic Kidney Diseases: Children can develop acute kidney injury (AKI) due to various causes such as infections, medications, or systemic illnesses. Chronic kidney disease (CKD) in children may result from congenital abnormalities, hereditary conditions, or acquired kidney diseases. Timely management is crucial to slow disease progression and prevent long-term complications.
Renal Tubular Disorders: Renal tubular disorders encompass a group of genetic conditions that affect the renal tubules' ability to reabsorb or excrete specific substances. Examples include renal tubular acidosis, Bartter syndrome, and Gitelman syndrome. Treatment aims to manage electrolyte imbalances and optimize renal function.
Dr. Sidharth Kumar Sethi
Kidney & Urology Institute
He was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of an 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and an Expert committee involved in the formulation of guidelines for Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of the Editorial Board of “The World Journal of Nephrology” and “eAJKD- Web version of the American Journal of Kidney Diseases”. He is a reviewer of Pediatric Nephrology related content for various Pediatric and Nephrology journals.
Nephrotic Syndrome
Most people have two kidneys, one on either side of the body just beneath the ribcage. Healthy kidneys filter the blood and allow small particles of waste products and water to be excreted as urine. Kidneys also play an important role in the control of blood pressure, maintenance of bone health, and formation of red blood cells.
What is nephrotic syndrome?
Nephrotic syndrome occurs when the kidneys leak large amounts of protein (especially albumin) into the urine. It is these proteins which is mainly responsible for holding water in the blood vessels, and when they are lost in urine, their level decreases in the blood which causes the water to come out of the blood vessels and cause swelling (edema).
What causes Nephrotic Syndrome?
In most cases, the exact cause of the nephrotic syndrome is not known. There is no relationship between diet or socioeconomic status of the family. It is non-infectious and does not transfer to other family members.
What are the symptoms?
The most common symptom is swelling (edema). It first appears on the face, especially around the eyes which is most prominent in the morning when the child gets up and decreases by the evening.
Other symptoms include Frothy urine, weakness, and tiredness, passing less urine than usual, recurrent infections, diarrhea.
What is the treatment?
Prednisolone (steroid) is the drug of choice when the child is first diagnosed. Most children respond to this drug with the disappearance of the protein in the urine and loss of swelling within 1-2 weeks (we call this REMISSION). Other drugs like diuretics, ACE inhibitors, etc may be required for symptomatic treatment.
Those who do not respond to steroids are given second-line drugs like Cyclophosphamide, MMF, Levamisole, and other immunomodulators as decided by your doctor according to the individual patient profile.
Conclusion:
Pediatric nephrology is a specialized medical field dedicated to diagnosing, treating, and managing kidney diseases in children. By focusing on early detection, comprehensive evaluation, and appropriate interventions, pediatric nephrologists play a crucial role in improving the health outcomes and quality of life for children with kidney conditions. Collaborative efforts between healthcare providers, ongoing research, and advancements in therapeutic approaches continue to advance the field of pediatric nephrology and benefit young patients with kidney diseases.
