What Is the Treatment for Nephritis in Children?

Pediatric nephritis generally refers to glomerulonephritis, which is a diffuse, non-purulent disease of bilateral kidneys. Occurs in school-age children, most commonly 6-9 years old. Often secondary to bacterial or viral infections in the upper respiratory tract, but the onset of nephritis is not inflammation caused by direct damage to the kidneys by bacteria or viruses, but caused by a series of autoimmune reactions in the body after pathogens invade the body, causing kidney damage. And sick.

Pediatric nephritis

Pediatric Nephritis Pathology

Glomerulonephritis, referred to as nephritis, is a group of acute onset, diffuse glomerular damaging diseases caused by immune response after infection caused by different etiology. The main clinical manifestations are edema, oliguria, hematuria, and hypertension, and the general course of disease is about 4-6 weeks. Summer and autumn are the seasons of pediatric nephritis, which are more common in children aged 5-12 years. Treatment of pediatric nephritis is not complicated, and nursing is important and plays a decisive role in prognosis. Children with nephritis need bed rest for 1-2 weeks. Because bed rest can reduce the body's energy consumption, reduce the burden on the heart, improve renal blood flow, and help prevent complications such as heart failure and hypertensive encephalopathy. Once the edema subsides, blood pressure stabilizes, and gross hematuria disappears, allowing the child to get out of bed and move indoors or walk outdoors. Early in the disease due to obvious edema, accompanied by azotemia, should be given a low salt and low protein diet. The daily salt intake is 1-2 grams, and the protein intake is 0.5 grams per kilogram of body weight per day, but chickens and duck eggs should be banned to avoid increasing the burden on the kidneys. Encourage children to eat more fruits until the children's edema disappears and normal blood pressure can resume the original diet.

Pediatric nephritis symptoms

Pediatric nephritis Generally, children with kidney disease have a slow onset, fatigue, fatigue, and loss of appetite. The age of onset of simple nephropathy is relatively small, mostly at the age of 2 to 7 years, and the age of onset of nephritis nephropathy is relatively large, mostly at the age of 7 years. Gender distribution is more male than female, 4: 1.

If edema is suspected of nephropathy, some examination items need to be done: blood routine, urine routine, double kidney B-ultrasound, renal function examination, and preliminary diagnosis can be combined with clinical symptoms.

Puffiness is the most obvious symptom of nephropathy in children: edema often occurs first, starting from the face and eyelids, and gradually spreading throughout the body, and the simple nephropathy is more highly edema. The finger pressure skin is sunken. In severe cases, the serous cavity is involved, and pleural fluid, ascites, and sheath appear Fluid and scrotal edema can cause difficulty breathing, diarrhea, or vomiting.

The edema recurs occasionally, and can even subside on its own. Nephritis nephropathy is less marked than simple nephropathy and can be extremely mild or even difficult to detect. Hypoalbuminemia results in malnutrition and developmental delay, manifested as disgraceful hair, dry skin, prone to rubbing and ulcers, pale fingers and toes, dull complexion, pale lips and white fur, fatigue and less movement in children, reaction Indifferent and prone to infection.

Clinical manifestations of pediatric nephritis

Pioneer infections such as acute tonsillitis and skin impetigo often occur 1-4 weeks before onset. Began to have symptoms such as low fever, dizziness, nausea, vomiting, and loss of appetite. These symptoms are not different from common fever infections, and are not easy to attract people's attention. They are often ignored. Edema and oliguria are the characteristics of this disease. Generally, the edema starts from the eyelid of the child and gradually expands to the whole body. Acupressure does not sag, and urine output decreases significantly during edema, even without urine. The urine output gradually increases within about 1-2 weeks, and the edema gradually subsides. Most of the children's hematuria is invisible to the naked eye, and only a small number of children can see the hematuria.

Pediatric nephritis The color of hematuria is bright red like meat washing water, and some like dark brown. This is related to the acidity and alkalinity of urine. I hope that we should pay attention to this when we observe the urine of children. Generally, the visible hematuria disappears within 1-2 weeks. The manifestations of children with hypertension are nausea, vomiting, and dizziness, but if the blood pressure rises too quickly, many serious complications will occur. At present, the medical and health conditions in Chinese cities have been greatly improved, and acute nephritis can be treated promptly when it starts. Therefore, severe cases are rare in cities, but they still occur in remote rural areas.

These serious diseases, such as early detection and timely treatment, can lead to death of children. In the early stages of the disease, the urine output of children was significantly reduced, swelling was increased, shortness of breath, rapid heart rate, irritability, and the condition could worsen sharply, difficulty breathing, unable to lie flat, pale gray, cold limbs, frequent coughing, and pink foaming Sputum indicates that the child has heart failure. If the child has severe dizziness, nausea, vomiting, and transient blindness in the early stages of the onset, and severe seizures and coma occur in severe cases, it is a manifestation of hypertensive encephalopathy. Some severe cases have acute renal failure at an early stage. If these situations are not dealt with in a timely manner, the consequences will be disastrous. When the child has a history of tonsillitis or purulent skin infection, and the symptoms of edema and oliguria appear, the child should be diagnosed and treated as soon as possible.

It is more common in children aged 3-8 years. It is rare in children under 2 years of age and has acute onset. It usually develops in 1-4 weeks after pioneer infection such as upper respiratory tract infection, skin infection, scarlet fever, etc., and the course of disease is within 1 year. Mild symptoms include microscopic hematuria, a small amount of proteinuria, and mild eyelid edema, or no obvious clinical symptoms; typical: acute onset, oliguria, edema, hematuria, and hypertension; severe: severe heart failure can occur in the short term, Acute renal failure, hypertensive encephalopathy, headache, vomiting, and coma.

Laboratory tests: Urine routinely showed hematuria and proteinuria. Granular casts, anti-streptococcus "O" or anti-streptokinase, anti-hyaluronidase increased, total serum complement and C3 decreased, mostly in 4 It returned to normal within -6 weeks, and the fibrin degradation product (FDP) was positive, the endogenous creatinine clearance was reduced, and the blood urea nitrogen was increased. Others: In some cases, chest enlargement shows that the heart is generally enlarged, the T wave changes in the electrocardiogram, and renal function damage is seen in different degrees

Pediatric nephritis diagnosis

1. A history of upper respiratory tract infection, tonsillitis, scarlet fever, or purulent skin infection is 1-4 weeks before the onset of history.

2. Swelling, hematuria, hypertension (18 / 1l-kpa).

Pediatric nephritis 3 In severe cases, any of the following complications can occur within one week of onset.

(1) Heart failure: manifested as shortness of breath, irritability, wet rales at the bottom of the lungs, rapid heart string, or galloping rhythm, and rapid liver enlargement.

(2) Hypertensive encephalopathy: headaches, flowers, temporary blindness, severe coma, convulsions, and significantly increased blood pressure.

(3) Acute renal insufficiency: oliguria or urination, azotemia, hyperkalemia, acidosis.

4 Laboratory inspection

(1) Urine routine: red blood cells, casts and proteinuria.

(2) ESR increased rapidly.

(3) Anti-streptocotin "O" (ASO) increased.

(4) Serum complement C3 decreases.

Pediatric Nephritis Treatment

Pediatric nephritis western medicine

(1) Antibiotic treatment: penicillin 5-10 million u / kg / day, divided into 2 intramuscular injections, or cefotaxime (Keflon) 50-100mg / L / day, divided into 2 intravenous drips.

(2) Diuretic; hydrochlorothiazide 1-2mg / kg / day, orally divided into 3 times. (3) Antihypertensive: reserpine O. 07 mg / kg intramuscular injection, or 0.02 mg / kg / day 3 times orally. For hypertensive encephalopathy, it is advisable to cooperate with other drugs, such as 5mg of sodium nitroxime dissolved in 100ml of 5% glucose solution, start 8-10 drops of Zhongjing drip, and adjust the drip speed according to blood pressure after 1-5 minutes, or 50% Magnesium sulfate 0.1ml / kg intramuscular injection.

Pediatric Nephritis Chinese Medicine

Acute phase

Feng Shui: Swelling of the eyelids, the whole body, bad wind, cough, oliguria, turbidity or hematuria, reddish tongue, thin white tongue coating, tight or floating pulse. Governing law: should be good for lungs and water. Recipe: 3 grams of ephedra, 25 grams of gypsum (first roasted), 10 grams of psyllium seed (package fried), 10 grams of Alisma purpurea, 15 grams of isatis root, 10 grams of scutellaria root, 10 grams of celestia, 15 grams of white grass

Damp heat impregnation: limb swelling, thirst and upset, chest tightness and bloating, skin soreness, headache and weight, urine turbidity or urine like strong tea or broth-like, red tongue, yellow greasy fur, slippery pulses. Governing Law: clearing away heat, dampness and detoxification. Recipe: 10 grams of almonds, 15 grams of business kernels, 6 grams of white courgette kernels, 10 grams of talc (fried pan fried), 3 grams of grass, 6 grams of pinellia, 6 grams of pinellia, 6 grams of cork, and 10 grams of thistle (each).

Pediatric nephritis Water and gas on the heart and lungs: limb edema, cough, shortness of breath, palpitations, chest tightness, irritability can not lie flat, lips cyanosis, nail cyanosis, white or greasy tongue coating, weak pulse count. Governing Law: Straight lungs benefit water, benefit the temperature. Recipe: 3 grams of ephedra, 6 grams of bellflower, 10 grams of diarrhea, 10 grams of aconite (fried first), 6 grams of cinnamon sticks, 1 grams of asarum, 10 grams of Radix Pseudostellariae, and Beiwujia. 10 grams of skin, 10 grams of evergreen, 10 grams of salvia, 6 grams of Sichuan pepper. Chinese patent medicine: Hei An Dan.

Evil heart and liver: headache, dizziness, nausea and vomiting, blurred vision, irritability, severe cases may suddenly appear convulsions, coma, red tongue and yellow fur, pulse strings. Governing Law; Pingganxifeng, Lishi Kaiqiao. Selection: 1.5 g of antelope horn powder (punch); Uncaria chinensis, Rotary flower (steamed), ochre, Scutellaria baicalensis, 10 g, gentian, diarrhea, plantain (steamed), angelica, habitat 10 grams each, 3 grams Mutong, 6 grams mandrill. Chinese patent medicine: Suhexiang pills.

Recovery period

Weak temper: body fatigue, pale, yellow, spontaneous sweating, appetite and dullness, pale tongue and white fur, 11 pulses. Governing Law: Spleen and Qi. Recipe: 10 grams of ginseng, 15 grams of astragalus, 10 grams of atractylodes, 10 grams of Poria, 3 grams of Zhigancao, 10 grams of angelica, 6 grams of peel, 6 grams of Cimicifuga, 6 grams of Bupleurum. Chinese patent medicine: Buzhong Yiqi Pill.

Kidney yin deficiency: dizziness, weakness, sore waist and legs, hot hands and feet, hot flashes, night sweats, red tongue, less moss or exfoliation, pulse count. Governing Law: Nourishing Yin and Kidney. Recipes: 10 grams each of Shudi, Shanlai , Alisma, Danpi, Poria, thistle, thistle, Achyranthes bidentata, Ligustrum lucidum, Eclipta prostrata, 12 grams of yam, and 15 grams of white grass root. Chinese patent medicine: Liuwei Dihuang Wan, Zhibai Dihuang Wan.

Pediatric nephritis diet

Anchovies and melon soup : 250 grams of anchovies, 500 grams of melon. Wash the sturgeon, remove the intestines and gills, and gourd (peeled) with decoction. Eat fish soup 2 times a day. Clearing the lungs and diuretic, swelling, suitable for acute stage of pediatric nephritis. Grass root soup: 250 grams of dried grass root and 25 grams of sugar.

Diet therapy Wash and chop the pin grass root, put it into a casserole, add an appropriate amount of water, the decoction will slag, then add white sugar, and melt and serve. The above is a 1-day amount, which is taken 2 to 3 times when the tea is warm to drink, and even served for 1 to 2 weeks, until the nephritis is cured. Clearing heat and diuresis. For children with acute nephritis.

Melon skin red bean soup : winter melon skin, watermelon skin, white grass root each 20 grams, corn must be 15 grams, red beans 200 grams. First put the red bean into the casserole, add an appropriate amount of warm water, and soak each other for ~ 2 hours; then put the melon peel, watermelon peel, white grass root, and corn into the casserole with red bean, add some cold water, and use it after boiling Let it simmer for another half an hour. The above is a 1-day amount. After frying, remove the residue and divide it into 3 times. Drink it warmly until the edema subsides. Water, swelling. It is suitable for unpleasant urination and general edema caused by acute nephritis in children.

Pepper eggs : 7 white peppers, 1 fresh egg. Place the top of the egg with a small hole in the thickness of the chopstick head with small scissors, put 7 white peppers into the egg from the hole, and use flour and dough to seal the small hole in the egg. Wrap the whole egg with wet paper When you get up, put it in a steamer or cook it in a bowl. After the steamed eggs are removed from the shell, eat the eggs and pepper together while hot, once a day, 10 times in a row for a course of treatment, and then take a second course after 3 days of rest, usually 3 courses. Treatment of chronic nephritis in children.

One-day recipe: The protein in the initial diet is limited to 11 grams per day, and salt is prohibited.

Breakfast: a bowl of sugar porridge. Dim Sum (9:00): 1 apple

Lunch: one bowl of white porridge, one egg yolk, yellow sprouts (100 grams), 10 grams of oil (for cooking)

Dim Sum (14:00): 1 boiled pear (100g), 20g sugar

Dinner: a bowl of white porridge, 60 grams of vegetables, 30 grams of potatoes, 10 grams of oil

Dim Sum (19: 00): an apple (100 grams)

Precautions for diet therapy: A, It is advisable to eat a diet without salt, low sodium, and semi-liquid: such as milk, porridge, vegetables, winter melon, watermelon, etc. Can not only remove heat and trouble, but also diuretic swelling. B. Foods that are moderate, digestive, and good for water: such as river fish. C, Yi Huang, Codonopsis, Motherwort can enhance immunity and disease resistance. D, Do not eat spicy and greasy, pickled foods. ^[1]

Diet for children with acute nephritis

1. Erchen Bamboo Leaf Tea: 10 grams each of Chen Pei and Chen Scoop, 20 pieces of fresh bamboo leaves, moderate sugar. Decoction until boiled, add sugar, this medicinal tea functions to relieve water and swelling, and is suitable for nephritis, spleen deficiency, dampness and edema.

2. Dried corn beard soup: 60 g of dried corn shall be fried with water and 500 ml to 250 ml, once served, once in the morning and evening, 1 g of potassium, 3 times a day. The medicated diet is a diuretic, suitable for nephritis edema. ?

3, Chinese cabbage and rice porridge: 500 grams of cabbage, 60 grams of barley. Boil rice porridge, add washed and chopped cabbage, the vegetables are hot, do not cook for a long time. Eat without salt or low salt, 2 times a day. This medicated diet is suitable for those with acute nephritis with edema and oliguria.

4, red bean carp carp: 100 grams of red bean, one carp (250 ~ 500 grams). Remove the carp from the internal organs, wash them out, and simmer for an hour with no salt. 1 or 2 times a day. The medicated diet has a beneficial effect on swelling and swelling, and is suitable for nephritis edema.

5, garlic steamed watermelon: 30 to 45 grams of garlic, a watermelon (about 1500 grams). First dig a hole in the watermelon skin, peel the garlic into the watermelon, then plug the hole with the dug melon skin, cover the hole with a small dish upwards, and steam over water. Eat it in portions during the hot day. The medicated diet functions to relieve swelling and is suitable for acute nephritis in children.

6. Red bean steamed black-bone chicken: one black-bone hen (weighing about 1500 grams), 300 grams of red beans, one spoon of rice wine, slaughtered with fine salt, hair removal, laparotomy, washing, draining, cutting into small pieces, washing red beans Net, take a large porcelain pot, pour half of the chicken pieces first, then half of the red beans, spread the chicken pieces and dirty people, and drizzle with rice wine. For sweet lovers, add sugar to the chicken nuggets and sprinkle a small spoonful of salt. Steam over high heat for 3 hours. When snacks or meals, one small bowl at a time, 2 times a day, this medicated diet function can strengthen the spleen and kidney, diuresis and swelling, and is suitable for children with mild nephritis and edema.

Pediatric nephritis prevention

Structure of the kidney Traditional Chinese medicine believes that the kidney is the innate foundation, the roots of the five internal organs and the six internal organs, and the main bones and the bone marrow, which connect the brain, are important organs for human growth, development, and reproduction. Therefore, kidney protection from childhood is vital to a person's life.

Pediatric nephritis

(Within one month after birth) At the beginning of this period, special attention should be paid to the separation from the mother, both in terms of diet and cold temperature regulation. Promote breastfeeding. Breastfeeding should be done regularly and every 3 to 4 hours during the day and 6 to 8 hours at night.

Pediatric nephritis

(Within 1 year of age) This period is the fastest period of human growth and development. In addition to milk, supplementary foods should be added to the diet to meet the needs of the body's development. Due to weak gas in the body, insufficient transport, slight carelessness, prone to stagnation of milk; qi and blood are not filled, muscles and bones are weak, and they cannot tolerate the attack of diseases such as wind, cold and heat, and should be strengthened to consolidate qi .

Pediatric nephritis in early childhood

(From 1 to 3 years old) During this period, various physiological functions tend to mature, and weaning should be performed. For example, if you breastfeed for too long, and do not enter other foods, you can weaken the spleen and stomach, cause malnutrition and affect development. After weaning in children, most of them do not know their diet and do not know their fullness after eating. It is necessary to properly control their diet and avoid eating and eating.

Pediatric nephritis

Pediatric nephritis in childhood

(From 3 to 7 years old) In this period, children are full of qi and blood, have enhanced disease resistance, strong imitation, and can carry out appropriate cultural and sports activities and exercise physical fitness. Make it grow well.

Pediatric nephritis in school

(From 7 to 14 years old) In this period, children continue to grow and develop, their stomach qi is becoming fuller, and then they begin to develop sexually, and then turn into adolescence. In this period, we should further strengthen physical exercise, strengthen our physique, and continuously improve our ability to adapt to changes in the external environment.

The physiological characteristics of childhood are that the body and physiological functions have not reached maturity and completeness, and they are susceptible to diseases and develop faster. Strengthening health and kidney protection in childhood has a positive significance in preventing kidney disease and prolonging life.