Glomerulonephritis symptoms and treatment in children. Glomerulonephritis in children (acute, chronic) - treatment, symptoms. The reasons for the development of glomerulonephritis

Glomerulonephritis- a disease of an infectious and allergic nature, which is accompanied by impaired renal function. It develops after a previous sore throat, scarlet fever, influenza, viral infections of the respiratory tract, chronic tonsillitis, pharyngitis, laryngitis, after a couple of weeks. Even a small abscess on the skin can cause this disease. In a sick child, streptococci are found on the skin and in the nasopharynx. Very often it provokes simple hypothermia of the body.

In medicine, there are two types of disease - chronic and acute glomerulonephritis in children, which differ in the causes and symptoms.

1. Sharp

The reason is a past infectious disease, the symptoms are pronounced, the child's condition deteriorates sharply. If detected early, it is treatable and proceeds in most cases without complications.

2. Chronic

Chronic, so-called diffuse glomerulonephritis is a more severe inflammatory process in the kidneys, which gradually leads to the death of the renal glomeruli. The cause of the disease is most often an acute form of glomerulonephritis that is not noticed, not treated in time. The main symptom is hypertension with all the ensuing consequences. Requires long-term inpatient treatment and recovery period.

Chronic glomerulonephritis occurs in children much less frequently: in 100 cases of acute development of the disease, only two are in the chronic course.

Symptoms

The symptomatology of an acute illness is pronounced, while chronic glomerulonephritis can hide and only from time to time make itself felt, continuing to undermine the small organism from the inside. The main signs of the disease begin to appear only 10–21 days after the infection that the child had to undergo. These include:

weakness;
thirst;
increased fatigue;
a decrease in the amount of urine excreted per day, the color of which becomes brown, black-coffee, or resembling the shade of meat slops;
the earliest symptom is gradual swelling, which first of all appears on the face, after a few days - on the lower back and legs;
one of the leading signs of the disease is hypertension: there is a simultaneous increase in both the maximum and minimum blood pressure, and this effect has a long, persistent nature (it does not go astray for three or more months) and is a kind of indication of the transition of the disease into a chronic form;
after that, visual impairment may already begin, the child increasingly complains of headaches, nausea, drowsiness in the middle of the day.

If the disease is not recognized in time by these symptoms, childhood glomerulonephritis can cause serious complications: acute renal and heart failure, cerebral edema. To make sure that these are signs of this particular pathology, a full-fledged diagnosis is carried out in stationary conditions.

Diagnostics

The diagnosis of glomerulonephritis in children is complicated by the fact that the signs of the disease are very similar to the symptoms. Therefore, conclusions are made on the basis of laboratory tests:

a lot of protein and traces of blood are found in the urine;
its specific gravity is either normal or increased;
significant changes in the blood, revealed during the analysis, which, in some forms of glomerulonephritis, remain in the child's body for life;
a reduced content of total protein is found in the blood serum;
ultrasound of the kidneys, ECG, radioisotope angiorenography, tests of Zimnitsky and Reberg, ultrasound (Doppler ultrasound) of the renal vessels are also carried out;
special equipment examines the fundus of the child, which confirms or refutes the diagnosis;
a kidney biopsy is prescribed for children only if chronic glomerulonephritis is suspected: this is how its activity is checked, kidney diseases with similar symptoms are excluded.

According to the results of these diagnostics, appropriate therapy is prescribed.

Treatment of glomerulonephritis in children

Almost always, the treatment of glomerulonephritis is carried out stationary using the following methods:

an appropriate drinking regimen is prescribed: the amount of liquid consumed by the child is limited to 1 liter or less;
the diet for glomerulonephritis should be protein-free and salt-free;
antibiotic therapy for 2-3 weeks;
diuretics;
in some cases, corticosteroid hormones may be prescribed;
bed rest;
plasmapheresis;
vitamin therapy;
pulse therapy;
surgical intervention: kidney transplant.

Treatment of glomerulonephritis in children in stationary conditions lasts from 1.5 to 2 months.

Prophylaxis

A child who has had glomerulonephritis will have to be under constant supervision of a nephrologist for five years. To prevent the disease from returning and worsening, it is recommended:

take urine for analysis on a monthly basis;
children are recommended to be protected from any infections that provoke the disease;
the child is exempt from sports and physical education.

Despite the fact that glomerulonephritis in children is quite difficult and requires such a serious, long-term treatment, in most cases the prognosis is still favorable: complete recovery with strict adherence to all medical recommendations.

Glomerulonephritis in children is classified as an immune-inflammatory lesion of the renal glomeruli, which leads to a decrease in their performance. Now this disease is one of the most common. Glomerulonephritis is twice as common in boys as in girls.

Acute glomerulonephritis in children develops as a result of inflammation of the glomeruli and thereby blocking the normal activity of the organ.

The disease develops due to inflammation of the glomeruli

During such a pathological process, fluid accumulates in the child's body, which leads to edema, increased blood pressure and the appearance of protein fractions and blood clots in urine.

Basically, the development of acute glomerulonephritis occurs against the background of infectious diseases such as tonsillitis, scarlet fever or pneumonia. In some situations, a banal vaccination can provoke a pathological process in a child's body.

Among other things, the following factors can lead to the occurrence of a disease such as glomerulonephritis:

tuberculosis;
flu;
chicken pox;
herpes;
hypothermia;
hypovitaminosis;
various foci of infections;
previous respiratory tract diseases;
genetic predisposition.

Also, glomerulonephritis can be a consequence of complications after postponed systemic diseases, such as vasculitis, endocarditis or lupus erythematosus.

The latent course of glomerulonephritis in childhood is quite rare, while in young patients pronounced manifestations are always observed.

The main symptoms of glomerulonephritis in children, indicating its development, are:

persistent headaches;
increased body temperature;
the occurrence of bouts of nausea, which mainly end in vomiting;
decreased performance, weakness and fatigue;
a sharp deterioration in health;
the appearance of puffiness on the eyelids and face;
pain in the lumbar region;
increased blood pressure;
discoloration of urine, which takes on a dark rusty hue;
decrease in the amount of urine.

The main danger of acute glomerulonephritis is that the disease can turn into a rapidly progressive form, as evidenced by the following symptoms:

the appearance of blood impurities in urine;
the presence of a large amount of protein in the urine, which can be manifested by the appearance of white flakes in it.

The appearance of blood impurities in urine is characteristic

If, when the first symptoms appear, timely treatment of glomerulonephritis in children is started, and also if, despite the prescribed treatment, recovery does not occur within six months, then the pathological process generally becomes chronic. In this case, edema and changes occurring in urine can be observed for one year or more.

In order to accurately determine the presence of the disease by the symptoms that appear, you should seek help from a pediatrician, urologist or nephrologist. Before prescribing a number of additional studies for a child, the doctor must first of all collect an anamnesis and only then decide on the necessary laboratory and instrumental diagnostic methods.

Thanks to these studies, the doctor will be able to identify the presence of signs of a developing inflammatory process, as well as determine the presence, decrease in urine output and hematuria, increase in ESR, as well as an increase in the blood of harmful substances.

The child needs to undergo a series of examinations for an accurate diagnosis.

In addition to laboratory tests, a small patient should undergo an ultrasound scan, an immunogram, and a study of the renal vessels. This is necessary first of all in order to determine the increase in the volume of the kidneys and to find out the complete picture of the disease. In some situations, a biopsy is recommended, which allows you to clarify the variant of the pathological process. Based on all the laboratory and instrumental examinations listed above, the doctor will be able to make an accurate diagnosis. In the event that the assumptions about the diagnosis are confirmed, then the child is assigned consultations of narrow specialists, such as an otolaryngologist, geneticist, dentist and ophthalmologist.

The acute form of glomerulonephritis in childhood is treated exclusively in stationary conditions under the close supervision of the attending physician.

When a child has a disease such as glomerulonephritis, the pathology is treated using the following conservative methods:

taking medications;
performing a set of exercise therapy exercises;
compliance with a strict pastel regime until the moment of recovery;
compliance with all rules regarding dietary nutrition.

As for taking medications, in order to cure glomerulonephritis in childhood, the following drugs are prescribed:

antibiotics;
cytostatics;
diuretic drugs;
blood pressure lowering agents;
hormonal drugs;
drugs aimed at reducing viscosity and normalizing blood clotting;
vitamin complexes;
means to increase immunity.

It is very important to follow a diet during treatment.

In the process of treating glomerulonephritis in children, it is also very important to observe. At the same time, it is recommended to adhere to the rules and nutrition of dietary table No. 7. Such nutrition is primarily aimed at reducing the amount of protein consumed, completely eliminating salt from the diet and limiting fluid intake.

Note! If acute glomerulonephritis becomes diffuse, then the patient must be prescribed a hemodialysis procedure or surgery.

Once the treatment is completed, the child should be monitored by a nephrologist for five years. In addition, after the illness, the child is issued an exemption from physical education, as well as ways to increase immunity and preventive measures to prevent infectious and inflammatory diseases are selected.

The child should be supervised by a nephrologist

Also, after treatment of the acute stage of childhood glomerulonephritis, if there are concomitant pathologies, it is strongly recommended to eliminate all foci of infections, as well as cure teeth, get rid of adenoids and all other diseases and abnormalities. But it is not worth doing this immediately after the treatment, at least six months must pass. This applies to both acute and chronic forms of glomerulonephritis.

The basis for the prevention of childhood glomerulonephritis is timely diagnosis and professional therapy of inflammatory and infectious diseases of the skin and upper respiratory tract. Unfortunately, at present, a vaccine against this insidious and dangerous disease has not yet been created, and as for the methods of prevention, they are considered very specific.

Among other things, it is very important from an early age to temper the child's body, as well as provide him with a balanced diet, systematic intake of vitamin complexes and means to increase immunity.

If you suspect the development of such a pathological process as glomerulonephritis in the child's body, you should immediately consult a doctor. This is very important, since even the slightest delay can lead to an aggravation of the situation and the emergence of various kinds of complications. It is strictly forbidden to self-medicate, as this can jeopardize the health of the child and even lead to complications such as uremia, heart or renal failure, or nephropathic encephalopathy.

To prevent the development of glomerulonephritis, you should follow some simple rules.

Also, in order to prevent the development of glomerulonephritis in childhood, the following recommendations should be followed:

limit salt intake;
systematically undergo examinations by a pediatrician for preventive purposes;
promptly treat allergic diseases;
avoid hypothermia of the body, as well as overheating.

As for the prognosis for recovery, if the pathology is diagnosed in a timely manner and all the recommendations of the attending physician are followed, the ability to get rid of glomerulonephritis increases significantly and the child can completely get rid of the disease.

With professionally prescribed treatment, the transition of pathology to the chronic stage, as well as the development of other complications, happens quite rarely, and cases of death are recorded in only two percent of cases.

Possible complications

If you ignore the symptoms indicating the development of glomerulonephritis for a long time or self-medicate, then serious and sometimes irreversible changes can occur in the body, such as:

renal eclampsia;
nephrotic encephalopathy;
uremia;
acute or chronic renal failure;
heart failure;
swelling of the lungs;
cerebral hemorrhage;
violent seizures.

Children's glomerulonephritis itself is considered a rather severe and complex disease. Cases of complete disposal of this pathological process are recorded quite rarely. One of the most common complications of this disease is its chronic form.

Glomerulonephritis is the second most common kidney disease in children. Most often it occurs at the age of 3 to 7 years and without timely treatment it becomes the cause of dangerous complications.

What is Glomerulonephritis?

The units of the urinary system of the kidneys - the nephrons - are made up of glomeruli and tubules. In the first, urine is filtered, in the second, it reaches the final composition and then enters the renal pelvis and then into the bladder.

What is Glomerulonephritis? - It is an inflammatory disease caused by infection, a defect in the immune system, or allergic causes. And if the disease pyelonephritis in children affects the tissues of the renal pelvis, then glomerulonephritis affects the glomeruli and tubules. This disrupts the normal filtration process of urine, as a result, its composition and quantity change - proteins and erythrocytes penetrate into it, which should not be.

As a result, the kidneys cannot cope with the excretory function, because of this, excess water and salts accumulate in the tissues and cells of the body, which leads to the development of edema and an increase in blood pressure.

In advanced cases, the disease leads to anemia, the development of heart failure and other serious complications.

Disease types

There are three main types of the disease:

chronic;
spicy;
subacute.

These types of disease have different severity of symptoms, and in childhood, the last two forms are more often detected.

Acute glomerulonephritis in children appears against the background of a previous illness of the upper respiratory tract and lungs (pneumonia, tonsillitis, ARVI). In this case, the most common factor is streptococcal infection. There are also cases of the development of this type of nephritis after the child is vaccinated.

Chronic glomerulonephritis in children(latent) is a consequence of an acute form that does not respond to treatment, or an acquired or hereditary anomaly of the immune system.

Types of disease due to:

primary - associated with congenital kidney damage;
secondary - is the result of a previous infection.

The main provocateurs of this pathology in a child are infections - more often bacterial, less often viral. The cause of glomerulonephritis in children can be, in particular, streptoderma and streptococcal dermatitis.

The general mechanism of the development of the disease with an infectious lesion of the body is as follows:

Bacteria or viruses that enter the body actively multiply and release toxins.
These harmful substances penetrate with the bloodstream into tissues and organs.
If they accumulate in the kidneys, then antigenic complexes are formed and the renal glomeruli become inflamed.
As a result, their lumen narrows, in some places the walls are soldered, and the filtering capacity decreases.

Acute and chronic glomerulonephritis in children can have different causes. The aggravated form is provoked by the body's reaction to foreign objects:

The chronic form of glomerulonephritis in children is more often secondary, developing due to the ineffectiveness of acute treatment, or this may be a hereditary disease, congenital or acquired defect of the child's immune system:

rheumatism;
endocarditis;
Alport syndrome;
Fabry disease;
periarteritis nodosa.

Hypothermia is a provoking factor for any form of glomerulonephritis, since low temperatures disrupt the blood supply to the urinary system.

In children, the latent course of the disease is extremely rare, and for the most part it is an acute form with a pronounced manifestation. Typical symptoms and signs of glomerulonephritis in children are:

A sharp deterioration in health;
Lower back pain;
Decrease in the amount of urine and its color in a dark rusty color;
Increased blood pressure;
Puffiness, especially noticeable on the eyelids and face;
Headache.

Very dangerous a rapidly progressive form of acute glomerulonephritis. In this case, additional signs are always:

Hematuria (impurities of blood in the urine);
Nephrotic syndrome (the presence of a large amount of protein in the urine, up to the formation of flakes).

The acute form becomes chronic if recovery cannot be achieved in 3-6 months. In this case, swelling and changes in urine persist for up to a year or more.

With the latent form of glomerulonephritis, most of the above symptoms are not observed. It is possible to recognize this variant of the development of the disease independently by the appearance of an admixture of blood in the urine. This is due to an increase in the number of red blood cells in it.

Symptoms of glomerulonephritis in children under one year old

Children from 0 to 12 months rarely get sick with glomerulonephritis. If the pathology develops, then the symptoms are very painful. The first thing that should alert the baby is the appearance of edema in the baby, darkening of urine and a decrease in its daily volume (the rate of urine output is presented in the table).

Age, months	1-3	4-6	7-9	10-12
Urine volume per day, ml	170-590	250-670	275-740	340-510

Nevertheless, there are cases of a latent course of the disease, in which the symptoms of glomerulonephritis in children under one year old are very difficult to recognize.

In this case, the presence of a disease can only be determined by urine analysis, which will show the presence of erythrocytes and protein in it. Another sign is an increase in blood pressure.

In addition to glomerulonephritis, there are pathologies similar to it in manifestations. For example, symptoms of pyelonephritis can resemble signs of such inflammation in children under one year old. Early medical attention and accurate diagnosis are critical to the success of treatment.

Methods for determining the disease

Diagnosis of glomerulonephritis in children includes:

examination of the child by the doctor;
general urine analysis;
Ultrasound of the kidneys and, if necessary, biopsy;
immunogram;
study of renal vessels;
serological blood test.

Some diseases have symptoms similar to glomerulonephritis, and only a complete examination allows an accurate diagnosis. For example, tests for pyelonephritis in children reveal an increase in the level of leukocytes.

Tactics for the treatment of glomerulonephritis in children

Acute therapy usually lasts from 10 days to a month and, if it starts early, it ends with recovery. For the treatment of glomerulonephritis in children, at the discretion of the doctor, the following are prescribed:

Antibiotics from a number of penicillins or others, depending on the specificity of the infectious agent;
Diuretic drugs;
Means for lowering pressure;
Prednisolone and cytostatics.

A therapeutic diet must be prescribed, and bed rest is indicated throughout the entire period of therapy. Urine tests are periodically performed to assess the success of therapeutic measures.

In the case of a high content of toxins in the blood, itching and icteric color of the skin, the presence of urine odor from the mouth, the attending physician prescribes a hemodialysis procedure. This is blood purification using the "artificial kidney" apparatus.

After completion of therapy, the child should be monitored by a nephrologist for five years after recovery. Children who have had glomerulonephritis are exempted from physical education, and also require increased protection against infections. In this regard, preventive measures against ARVI and other infectious diseases, strengthening of immunity are important.

Diet for glomerulonephritis in children

The nature of the diet is aimed at relieving edema. At the first stage of treatment, until the daily volume of urine excreted is normalized, salt and proteins are minimized - cottage cheese, eggs, fish and meat are excluded.

Therapeutic diet No. 7a for glomerulonephritis in children provides for a sharp restriction of these foods and a moderate decrease in carbohydrates and fats.

Food should be predominantly vegetable, steamed or baked; spices and spices should not be added to dishes. Only salt-free bread is allowed, products should not contain oxalic acid, you can give your child fruits and sugar.

Preventive measures and prognosis

The first condition for the successful prevention of glomerulonephritis in children is the correct and timely treatment of infectious diseases of the upper respiratory tract and skin. If the child is sick, it is necessary to pass a urine sediment analysis. This will help detect inflammation in the kidney tissue, if any.

It is of great importance to increase the resistance of the child's body to infections: hardening, taking vitamins, balanced nutrition and other ways to strengthen the immune system. All this applies equally to the prevention of pyelonephritis in children.

A successful prognosis for glomerulonephritis depends on the therapy started on time. Delay can endanger the health of the child, causing heart failure, uremia, and nephrotic encephalopathy.

Therefore, at the slightest suspicion of a disease, you should immediately consult a doctor and begin treatment.

Glomerulonephritis is usually called kidney disease, in which the glomeruli or intercellular tissue of the kidneys are affected, sometimes the renal canals also suffer.

Glomerulonephritis in children can be both chronic and acute, has an infectious-allergic disease.

Children aged from five to twelve years old are susceptible to this disease.

It is possible to identify the cause of this pathology in children in 80-90%, but in the case of a chronic form, only in 5-10%. Such a run-up in percentage is due to the fact that the main causes of glomerunephritis are infection.

Enterococci - causative agents of the disease

The development of an acute form can be facilitated by a sore throat, pharyngitis, scarlet fever, pneumonia, impetigo, streptoderma and other diseases provoked by streptococcal bacillus, transferred in two weeks.

Chronic glomerulonephritis in children develops as a result of an untimely cured inflammatory process.

The main reason for the development of glomerulonephritis is the genetic component of a deterministic immune response to antigens inherent in each individual organism.

As a result of this response, specific immune complexes are formed, which damage the weak capillaries in the renal glomeruli. Such damage, in turn, leads to disturbances in microcirculation, and then to inflammatory and dystrophic changes in the kidney.

Glomerulonephritis often develops with connective tissue diseases. In addition, the disease can develop in the presence of a hereditary abnormality, for example, dysfunction of T cells or with a hereditary deficiency of C7 and C6 complement and antithrombin fractions.

Children may be at risk of developing glomerulonephritis if they have a burdened heredity, they are carriers of nephritic stamps of group A streptococcal infection, have an increased sensitivity to streptococci, or they have a focal chronic infection on the skin or in the nasopharynx.

For the development of glomerulonephritis from a latent streptococcal infection, it is enough to supercool the body, get sick with ARVI.

The course of the disease in children can be influenced by physiological features. So in children, the course of glomerunephritis can be complicated by functional immaturity of the kidney, as well as a kind of reactivity of the body (change in immunopathological reactions).

If the child has a chronic loose throat, a swab should be taken for strep infection. After all, there is a high probability of complications in the form of glomerulonephritis.

Kinds

Glomerulonephritis occurs with an inflammatory process in the glomeruli of the kidneys. In these sections, the blood is filtered from metabolic products. When there is a dysfunction in the kidneys, in addition to metabolic products, blood elements and proteins are also subjected to filtration. Subsequently, when a virus or infection enters the body, antibodies are produced that destroy the harmful bodies.

Types of glomerulonephritis

Normally, the remnants of antibodies and viruses are removed from the body, but with glomerulonephritis they cannot be removed, they settle in the glomeruli. As a result, antibodies begin to perceive the kidney tissue as an enemy agent, thereby disrupting its work.

Pathology is classified based on the course of the disease, the agent that caused the inflammation, the degree of kidney damage, the main symptom:

primary- arises independently;
secondary- occurs against the background of complications from a chronic focus.

According to the degree of damage, glomerulonephritis is divided into:

diffuse glomerulonephritis in children- the entire organ is affected;
focal- the inflammatory process is localized in one place.

The severity of the course is distinguished:

chronic;
subacute;
spicy.

According to the leading manifestation of symptoms:

latent;
hypotensive;
nephrotic;
mixed;
hematuric form of glomerulonephritis in children.

Doctors advise you to be attentive to your children, monitor their stools, as well as the frequency of going to the toilet.

Symptoms

Acute glomerulonephritis in children has pronounced symptoms, while a chronic disease can be felt only occasionally. The main signs of the disease may appear 10 -21 days after an infectious disease.

With the development of a pathology such as homerulonephritis, the symptoms in children are as follows:

increased fatigue;
thirst;
a small amount of urine, sometimes red or chocolate colored;
weakness;
swelling, on the face, and then on the legs and lower back;
hypertension - the patient's lower and upper blood pressure rises sharply, the increase is persistent.
vision deteriorates, nausea, headaches, drowsiness may appear.

If you do not pay attention to the symptoms in time, then glomerulonephritis can lead to serious and irreversible changes in other organs. As a rule, the liver and heart are affected, and cerebral edema may develop.

Treatment of glomerulonephritis in children

The disease is treated exclusively in a hospital setting, subject to bed rest and dietary food.

The diet for glomerulonephritis in children is to prohibit protein foods, salt.

Etiotropic and pathogenetic therapy is carried out, as well as symptomatic treatment in the presence of unpleasant concomitant symptoms.

A salt-free diet allows you to quickly remove swelling, and a protein diet is designed to restore the normal volume of urine excreted.

If acute glomerulonephritis is diagnosed, treatment in children is based on taking antibiotics, Ampicillin, penicillin, Erythromycin are prescribed. Edema is also treated with medication, or Spirolactone is prescribed.

Ampicillin

I often prescribe antihypertensive drugs, glucocorticosteroids, blockers (Nifedipine, Lazartan, Valsartan) or immunosuppressive drugs.

When nephrotic syndrome is pronounced, the doctor may prescribe anticoagulants or antiplatelet agents to avoid thrombosis of the kidney vessels. If the child has an increase in the level of urea or uric acid, as well as creatinine in the blood, hemodialysis is prescribed. After stabilization of the condition, the children are registered at the dispensary for 5 years. With chronic glomerulonephritis in children, the prognosis is as follows - if there are cases of relapse, then for life.

As you know, in the first years of life, a child is distinguished by unstable immunity. Even a small ailment can provoke many serious complications. In the autumn-winter period and at the beginning of spring, the increase in the incidence of renal pathologies sharply increases. The most common of these is glomerulonephritis. This ailment occurs annually in more than six hundred thousand children around the world and often ends unfavorably. That is why it is so important to know the first signs of the development of glomerulonephritis in children, as well as ways of providing assistance and various treatment options for the disease.

What is the disease

Glomerulonephritis is a disease in which inflammation damages the renal glomeruli, which are involved in filtering and purifying the blood. Often the ailment is called jade in an abbreviated form. Pathology often occurs in children at all age periods, but newborns and adolescents 12-17 years old are most susceptible to it.

The renal glomerulus filters and purifies the blood, when it becomes inflamed, the kidney function is impaired

With glomerulonephritis, the renal tissue becomes edematous, the vessels are squeezed. Often this leads to the necrosis of small areas and the development of a connective substance in their place, which cannot perform the functions of filtering and purifying the blood.

Varieties of pathology

Nephrologists classify the disease according to its characteristics. So, depending on the causes of occurrence, glomerulonephritis is isolated:

Primary (develops in a healthy body):
- caused by the damaging effect of immune complexes:
  - acute post-streptococcal - after a sore throat, characterized by a sudden increase in temperature and the rapid development of the clinic in a couple of days;
  - chronic - has existed for several years;
- rapidly progressive - a symptomatic picture occurs in a matter of hours, is an extremely unfavorable pathology.
Secondary (formed against the background of already existing diseases of the liver, kidneys, heart).

Varieties of acute glomerulonephritis, depending on the clinical manifestations:

with nephrotic syndrome (accumulation of fluid in soft tissues, the appearance of blood in the urine);
with nephritic symptoms (a large amount of protein in the analyzes and pain in the lumbar region);
with urinary syndrome (changes in urine: the predominance of inflammatory cells and salts);
combined form (combines the features of all the above pathologies).

Types of chronic glomerulonephritis, depending on the symptoms:

nephrotic (accompanied by swelling, the presence of red blood cells in the urine);
hypertensive (characterized by an increase in blood pressure);
mixed.

Video: what happens to the kidneys with glomerulonephritis

Why does glomerulonephritis develop in children?

The main reason for the formation of kidney disease in babies is the penetration of microbes. Most often, the causative agent is:

But the mere presence of microorganisms is not enough. For the development of glomerulonephritis to occur, the influence of the following factors is also necessary:

hypothermia;
frequent change of climatic zones;
weakened immunity;
improper nutrition;
recent surgery or injury.

The clinical picture and the first signs of pathology

The course of glomerulonephritis in children is characterized by a combination of general and local manifestations. The body of a baby differs in many respects from the body of an adult: their inflammatory processes are much more intense and with greater intoxication. That is why it is so important to start treatment of the disease in a timely manner and prevent the development of complications.

Common manifestations:

an increase in body temperature up to 38-40 degrees;
nausea and vomiting after eating;
swelling of the face and upper half of the body;
headache;
tearfulness, refusal to eat;
loss of body weight;
blood pressure indicators are 20-40 millimeters of mercury higher than normal;
sleep disorders (insomnia, waking up during the night).

An increase in body temperature often indicates an inflammatory process.

Local symptoms include:

pain in the lumbar region of an aching nature, which can radiate to the perineum, abdomen or thigh;
changes in urine analyzes (turbidity, the appearance of protein, blood and pathological impurities);
swelling of the lower back;
cramps, burning when urinating.

Methods for Diagnosing Glomerulonephritis in Children

Since all kidney diseases have a similar clinical picture, it is often necessary to differentiate them among themselves. Glomerulonephritis should be distinguished from:

pyelonephritis;
urolithiasis;
malignant and benign neoplasms;
cystitis;
urethritis.

Often there is a combination of several diseases with each other, which significantly complicates the work of a doctor.

The author had a chance to participate in the treatment of a 7-year-old boy who developed glomerulonephritis against the background of urolithiasis. Since the clinical picture was rather blurry, an ultrasound examination had to be performed. So the doctors found that in addition to a stone in the ureter, the child had changes in the structure of the kidneys, characteristic of glomerulonephritis.

Diagnostic techniques:

How to get rid of a problem in childhood

As soon as the diagnosis of glomerulonephritis has been suspected and confirmed by a doctor, the parents receive a referral for hospitalization. Treatment is carried out in the Department of Nephrology or Urology by pediatricians.

The tactics of treating glomerulonephritis is largely determined by the form of the disease (acute or chronic process), the age and condition of the child:

When the disease is at an early stage of development, the symptoms are mild, and doctors begin with a gentle diet and the use of pharmaceuticals.
If the disease progresses steadily, and complications also appear, you have to resort to surgical intervention.
Physiotherapy is widely used during the recovery and rehabilitation phase of kidney function.
Some folk remedies can be used to reduce symptoms (after consulting a doctor).

The main goals of treating glomerulonephritis in children are:

improved blood supply to soft tissues;
increased outflow of lymph from the affected kidneys;
normalization of urine excretion;
reducing the severity of pain and inflammatory edema;
preventing the development of bacterial complications;
strengthening the baby's immunity;
stabilization of water-salt and electrolyte balance;
prevention of acute and chronic renal failure.

Drug treatment for glomerulonephritis

To restore the functions of the urinary system, doctors resort to the use of pharmaceuticals. All medicines prescribed by doctors can be roughly divided into two groups:

agents affecting the causative agent of the disease (etiotropic);
drugs to get rid of clinical manifestations (symptomatic).

The combination of these methods helps the body fight glomerulonephritis more actively.

Dosages of drugs for children are selected based on their weight and age. That is why pediatricians forbid parents to engage in therapy on their own.

The etiotropic treatment of pathology includes the use of antibiotics. These drugs allow you to disrupt the life cycle of the microbe that caused glomerulonephritis, and also contribute to its death and elimination from the body. The most common in pediatric practice are:

Augmentin;
Azithromycin;
Zinacef;
Sumamed.

For symptomatic therapy, the following groups of drugs are used:

Anti-inflammatory drugs - relieve swelling of soft tissues and reduce the severity of pain, as well as lower body temperature. The drugs can be used both in tablet form and in the form of rectal suppositories. Most often used:
- Paracetamol;
- Ibuprofen;
- Nurofen;
- Nise.
Detoxification and infusion solutions - help to remove toxic substances from the body and protect the cerebral cortex from damage, as well as restore the water-salt balance. Their introduction is carried out using a dropper. Used in pediatrics:
- Disol;
- Trisol;
- Regidron;
- Reopolyglyukin;
- glucose.
Immunostimulants - increase the formation of cells that are responsible for the destruction of bacteria by the body itself. They can be taken in the form of tablets, rectal suppositories, or intramuscular injections. Popular drugs:
- Cycloferon;
- Timogen;
- Timalin;
- Taktivin.
Antispasmodics - help to relax the smooth muscles of the urinary system and facilitate the passage of urine. In pediatrics, No-shpa is used, as well as herbal medicines (given to the baby before bedtime to alleviate his condition):
- peppermint;
- Dill seeds;
- valerian;
- melissa.

Photo gallery: drugs for the treatment of ailment in children

Ibuklin - anti-inflammatory agent with antipyretic effect
Acesol - a solution to normalize the water-salt balance in the body
Flemoxin Solutab is a broad-spectrum antibiotic that kills many pathogenic microbes
Viferon rectal suppositories help the body to activate its own forces to fight the disease
No-shpa has an antispasmodic effect, reduces pain during urination

Features of diet and drinking regimen for children with glomerulonephritis

The baby's body spends a huge amount of energy to fight the disease: this is why a serious loss of body weight is characteristic. To replenish the nutritional deficiency, it is necessary to normalize the child's diet.

Particular attention should be paid to the drinking regimen: in order to remove toxins and toxins from the body, doctors recommend drinking more pure non-carbonated water (up to one and a half to two liters per day). Carbonated drinks, packaged juices and mineral water can only aggravate the situation and provoke the development of urolithiasis. It is necessary to cook food by boiling, stewing and baking: fried foods are prohibited with glomerulonephritis.

The largest number of calories should be absorbed by the child for lunch, breakfast and dinner make up a much smaller part. Do not forget about snacks: healthy bread and muesli will help you not to kill your appetite before the main meal.

Children with glomerulonephritis need to eat the following foods:

kefir, yogurt, cottage cheese, milk, sour cream, cheese;
hard pasta;
legumes;
lean meat and fish;
vegetables (in the form of mashed potatoes, soups, cuts, salads);
berries and fruits (in the form of fruit drinks, juices, compotes);
nuts;
cereals (buckwheat, oatmeal, rice, millet, pearl barley).

Photo gallery: healthy food for illness

Nuts are a great option for an afternoon snack
Cottage cheese contains a lot of calcium and protein, which are necessary for the child's body. Vegetables and fruits - a storehouse of vitamins and minerals Cereals will be a good source of essential vitamins and minerals for children.

Table: the role of physiotherapy in the treatment of ailment

Method name	How is the procedure performed	Desired effects
Inductothermy	Application of magnetic fields of various frequencies and intensities	Reducing the severity of pain and swelling, normalizing urination
Point effect of laser beams on the area of the kidney	Prevention of the development of adhesions and growth of the connective substance
Medicinal electrophoresis	Using an electric current to inject pharmaceuticals into your baby's body	Faster delivery of the drug into the body, accumulation and creation of the required concentration in the tissues
Massage	Stimulation with circular and pinch movements of various areas of the body	Improvement of blood microcirculation in the vascular bed, prevention of venous stasis and thrombosis

Photo gallery: physiotherapy for illness

Massage movements are widely used to improve metabolic processes in tissues. Electrophoresis is absolutely painless for a child, but it has a good healing effect. Due to the targeted action of laser beams, there is no proliferation of connective tissue

Surgical treatment of glomerulonephritis in children

The indications for surgery are:

lack of effect from conservative therapy for six months;
the formation of acute or chronic kidney failure;
development of nephrosclerosis - proliferation of connective tissue;
serious condition of the patient;
death of one kidney;
the occurrence of a secondary infection and the occurrence of an abscess, phlegmon, carbuncle.

In newborns and children of the first year of life, surgical treatment is carried out in extremely rare cases, since they respond well to the use of pharmaceuticals.

The duration of the operation is from two to five hours

The operation is performed under general or spinal anesthesia. The sequence of actions is as follows:

After immersing the little patient in the doctor's sleep, using an incision in the lumbar region (if the endoscopic technique is used, the size of the wound does not exceed a few centimeters), soft tissues are severed: skin, fatty tissue, muscles, and the kidney is also brought to the surface.
Further, surgeons carefully study the state of the organ: the presence of wrinkling, hemorrhages, purulent processes and cicatricial adhesions is an indication for removing a site or all affected tissues.
Clamps are applied to the neurovascular bundles, after which the foreign bodies are excised.
At the end of the operation, doctors wash the wound area with saline or an antibacterial agent, carefully and consistently suture the tissues, installing small drains - tubes through which lymph and blood flow.
The little patient is transferred for several days to the intensive care unit, where doctors and nurses monitor him.

As soon as the child becomes stable, he is returned to nephrology to continue conservative treatment and subsequent rehabilitation measures.

Alternative therapy of the disease as an additional remedy

Previously, it was believed that the use of various herbs, plants and berries can partially restore kidney function and have minimal impact on the health of the child. However, at present, doctors are sure that alternative medicine helps only slightly alleviate the symptomatic manifestations of the disease, but is not able to cure its cause. When combining natural remedies with pharmaceutical products, truly tremendous results can be achieved in the treatment of glomerulonephritis in babies.

Do not forget that many plants, fruits and herbs are quite strong allergens for a child.

On one occasion, while working in a department of a children's hospital, the author was involved in treating a boy who was admitted urgently with anaphylactic shock and severe suffocation. As it turned out, the parents decided to use the herbal tea in the treatment of the disease without consulting a doctor. They brewed several spoons at once, without calculating the weight and age of the child. As a result, the baby had an acute allergic reaction to one of the components of the collection, which led to suffocation. They managed to resuscitate the little patient, but the child experienced severe stress, which contributed to a delay in neuropsychic development. That is why doctors recommend starting with a small dosage (one teaspoon), after which monitor the body's reaction.

Here are some folk remedies that can be used to treat glomerulonephritis in children:

Mix one hundred grams of freshly frozen cranberries with the same amount of blueberries and place in a saucepan with two liters of water. Simmer for half an hour and then add a few tablespoons of honey to enhance the taste. Once the liquid has cooled, give your child half a glass a day before and after meals. Cranberries and blueberries are not only universal sources of vitamin components, but also the best folk remedies that relieve inflammation. It is recommended to use this treatment at least twice a week for six months.
Cook fifty grams of rose hips over low heat in a saucepan with a liter of water for fifteen minutes. Using a sieve, remove the fruit and cool the liquid. It is necessary to give the baby one glass before breakfast, lunch and dinner. Rosehip stimulates the activity of the immune system and has antimicrobial effects. It is necessary to undergo a course of twenty procedures, after which the broth can be consumed for preventive purposes at least twice a week.
Brew one tablespoon of chamomile in a glass of boiling water. After cooling down, give the baby a drink in small sips (preferably before bedtime). Chamomile gently relieves spasms and reduces the severity of pain, which makes it an indispensable remedy for glomerulonephritis. It is recommended to be treated in this way for up to three months in order to achieve the expected result.

Photo gallery: folk remedies used for ailment

Cranberries are rich in vitamins B and C and also have antimicrobial properties Rosehip is the best remedy for strengthening the immune system Chamomile has a sedative and antispasmodic effect and will help your baby sleep through the night.

Treatment projections and possible negative consequences

Such a pathology in childhood is quite easy to treat with a timely visit to a doctor. On average, the duration of treatment of pathology is from two weeks to six months. If the parents visited the doctor too late, the duration of therapy can be up to several years. In this case, factors such as are important:

the presence of other acute or chronic diseases;
recent infections, trauma, surgery, radiation and chemotherapy;
hereditary pathologies;
baby's body weight;
the age of the child.

If glomerulonephritis is diagnosed within a period of one to three years, the prognosis is extremely favorable. About 97% of renal function is fully restored. In the case when the pathology was diagnosed in adolescence and it is combined with other ailments, disability may develop.

The success of treatment and rehabilitation is largely influenced by the patient's lifestyle and compliance by his parents with all medical recommendations. In his clinical practice, the author came across a teenager who had been suffering from exacerbations of chronic pyelonephritis for two years. At the same time, he refused to take medications, did not attend physiotherapy procedures and ate mainly fast food and fried foods, which led to the development of obesity. The parents could not influence the child in any way, which ultimately led to extremely unfavorable consequences. The boy was admitted to the intensive care unit with acute renal failure. Due to complications, he developed necrosis and death of one kidney, and it had to be removed. The patient now has to attend hemodialysis procedures for life - artificial filtration of blood through a membrane system.

What complications can occur in children with glomerulonephritis:

How to protect your baby from developing the disease

From an early age, parents take care of their child in every possible way and protect his health. In this they are also helped by pediatricians - pediatricians, who monitor the baby from the very moment of his birth. Currently, regular patronage examinations for infants are being carried out, during which the doctor examines the state of health and determines the existing pathologies.

Medical sciences have gone far ahead compared to the last century: if earlier it was believed that it was easier to choose an individual treatment regimen for everyone, now doctors are mainly engaged in the prevention of various diseases. This tactic did not bypass the problem of glomerulonephritis - events dedicated to the therapy and diagnosis of pathology are organized annually in cities and large villages.

As you know, many people know quite little about the child's body and its characteristics. In order to help parents, the author, together with his colleagues at the bases of various hospitals, hospitals and outpatient clinics, organized special seminars that were devoted to the problem of glomerulonephritis in babies. Anyone could get to such an event: someone came just to listen and record new information, while others brought the child for urine and blood tests, as well as for a comprehensive examination. After analyzing the results obtained, it was revealed that about 20% of all children suffered from acute or chronic glomerulonephritis, while only 5% presented active complaints. In 3% of babies, parents preferred to deal with the problem on their own or ignore it, which led to adverse consequences in the form of renal failure. A hereditary pattern was also identified: if mom or dad had kidney problems, then in 90% of cases the child suffered from a similar ailment. Parents were given special recommendations for the prevention of glomerulonephritis, and children were offered hospitalization and various treatment options.

How to protect your baby from the development of such a pathology:

Give your child all the mandatory vaccinations by age in the absence of medical contraindications. Vaccination is one of the most important methods of forming and stimulating the human immune system. Many weakened bacteria, viruses and their toxins are introduced into the body in small quantities. This helps, upon contact with a real pathogen, to activate the baby's immunity and contributes to an easier and safer course of the disease. It is known that about 70% of children suffering from glomerulonephritis did not receive prophylactic vaccinations.
Vaccinations help build a child's immune system
Limit your baby's eating the wrong foods. Harmful food slows down metabolic processes in the body and makes it less resistant to adverse environmental factors.
Visit your pediatrician regularly and have all the necessary medical examinations. This will make it possible to diagnose the development of pathological changes in urine and blood tests in a timely manner. About 30% of all cases of glomerulonephritis in childhood occur with minimal clinical symptoms, and they can only be detected by examining biological fluids. That is why it is necessary to show the baby to a specialist at least once every six months.
Try to dress your child appropriately for the weather conditions. Too light jacket and the absence of a hat can lead to the development of colds and tonsillitis, which is often complicated by glomerulonephritis. However, warm clothes in hot weather can also play a cruel joke on the baby's health, provoking severe sweating and impaired thermoregulation. Pediatricians advise you to choose several optimal suits for a walk that will protect you from strong winds and will not allow you to freeze in winter and overheat in summer.
Teach your kids to be active. To keep the growing body in good shape, it is necessary to ensure its motor needs: take the baby to the sports section or regularly do light gymnastics and exercises with him in a playful way. Physical activity will help strengthen the immune system and protect the child's body from the action of harmful microbes.
Sports activities strengthen the body, allow you to better fight microbes

Glomerulonephritis in children is a complex problem that has not lost its relevance for several decades. That is why doctors strongly recommend monitoring the health of your baby and paying attention to the slightest differences in his health. Even minor whims and tearfulness can be symptoms of the development of an ailment. You should immediately go to the hospital without trying to treat the disease with folk methods or take medications without a doctor's prescription. This often ends in poor outcomes and even disability.