Sick kidneys in a child. Causes of kidney diseases in children. Kidney diseases in children: treatment

The kidneys are a vital organ responsible for the water-salt and acid-base balance of the body. They remove many substances, including products of intoxication of the body resulting from bacterial and viral infections. The activity of the kidneys cannot be called autonomous from the life of the whole organism; it is closely connected with other systems and may suffer from disruption of their functioning. Children's bodies are especially sensitive to viral and bacterial attacks, which increases the risk of developing inflammatory diseases in the kidneys.

Causes and symptoms of inflammation in children

Inflammation of the kidneys is the general name for a group of diseases expressed in inflammatory reactions in various parts this organ. They are also called nephrite (from the ancient Greek “kidney”) and are divided into types, the most famous of which are:

Kidney inflammation in a child can have various causes. The risk group includes children aged three to seven years, especially if they have older relatives with kidney disease or pathology. The main causes of inflammatory processes in children:

complications after ARVI and diseases of the upper respiratory tract(tonsillitis, tonsillitis, sinusitis, etc.);
bacterial infections that affect the kidneys through urinary tract (coli, coccal infections, etc.);
previous skin infections and scarlet fever;
autoimmune reactions after a streptococcal infection;

It is important to understand that nephritis is a consequence of infection, a peculiar reaction of the body to pathogenic flora. This makes it more difficult normal functioning kidneys - their filtering capabilities change, urine formation is disrupted.

The risk of developing inflammatory processes increases with:

anomalies in the structure and development of the urinary system;
genetic predisposition to kidney diseases;
presence of chronic diseases;
hypothermia and a decrease in normal blood supply to the kidney due to this;
insufficient attention of parents and children to the rules of hygiene - regular washing, changing clothes or diapers, etc.
disordered eating, lack of normal taste habits and rare drinking of water.

Girls suffer from nephritis more often than boys; this pattern is explained by the structure of the lower sections genitourinary system.

There are no age limits - kidney inflammation can develop in both an infant and a teenager if at least one of the risk factors is present.

Regardless of the type and nature of the disease, general symptoms, indicating the presence inflammatory reaction in the body and the affected organ. The most obvious among them:

If a child is bothered by at least one of these signs, it is worth contacting a pediatrician or nephrologist in order to conduct a timely examination and stop the inflammation.

Important! It should be noted that nephritis can also be asymptomatic, being detected already in the acute stages, which significantly complicates the treatment and the process of restoring normal kidney function.

Individual symptoms may indicate the nature of the affected area of the kidneys. For example, glomerulonephritis is characterized by swelling and increased pressure; laboratory tests of urine reveal a large number of blood and protein. With pyelonephritis in children, more frequent and painful urination, loose stool, in infants - frequent regurgitation.

Treatment of nephritis in children

Timely examination and treatment will avoid transition acute inflammation V chronic diseases. The kidneys are an organ capable of fairly rapid recovery, and in childhood this property is especially important. At correct diagnosis and with careful treatment, this organ is able to recover and continue to function normally. However, when careless attitude Complications to the disease are possible, including kidney failure and death.

The consequences of chronic kidney inflammation should also not be underestimated - these are serious risks for the future implementation of normal reproductive function in men and women, complicated pregnancy. Therefore, the attitude towards the prevention and treatment of nephritis should be extremely serious.

Drug treatment

Staying in hospital under regular supervision medical personnel. This allows not only to constantly monitor the dynamics of the disease, but also to more easily implement the obligatory recommendation of the nephrologist - bed rest.

Drug therapy is prescribed only by a doctor in accordance with accurate diagnosis. It includes taking diuretics, antibacterial, anti-inflammatory, antihistamines and immunostimulating drugs:

Additional therapies

Except drug treatment, the treatment regimen for inflammatory processes in the kidneys in children includes several more points:

Important! Symptoms of kidney inflammation in children, regardless of their age, should not be ignored by parents.

As a rule, children cannot adequately express their feelings. Pain, illness and other signs of illness may include crying, sudden changes behavior, irritability and withdrawal. With an attentive and kind attitude of parents towards the child, it is possible to identify the first signs of illness, stop the development of inflammation and its transition to more serious forms of disease in time.

Kidney disease in children is common. They suffer more often than adults; the cause of such disorders is weak immunity. In addition, children suffer more severely from any inflammation, with a number of complications. It is important to recognize the disease early stage so that the disease does not become chronic.

Main reasons

The genitourinary system is formed at the stage intrauterine development fetus After birth, the paired organ continues to grow. After a year and a half? In children, the kidney is fully formed and has normal sizes. Kidney disease is often diagnosed in the first years of life, but sometimes abnormalities are also detected in adolescents.

The causes of the development of the disease are congenital or acquired. The first include defects that appeared during intrauterine development. The cause of such anomalies is the mother’s illnesses during pregnancy or her poor lifestyle.

In children, kidney disease can result from:

Transferred or chronic pathologies. Disturbances can be caused by sore throat, tonsillitis, diabetes.
Food, drink. Plays a huge role in the development and function of the kidneys proper diet. It is important to pay attention to the amount of fluid consumed; a normal volume of water does not allow you to delay pathogenic bacteria in the ducts.

The body's defenses. Kidney disease in children is often diagnosed when the immune system is weakened.
Hygiene. Affects the condition of the genitourinary system in children and proper care, in the absence of regular washing, bacteria penetrate the kidneys and provoke inflammation.
Hypothermia. A common cause of kidney disease in children is cold kidneys; girls are most susceptible due to their anatomical features.

Congenital pathologies

The cause of kidney disease is most often congenital anomalies. Such deviations are the result of an incorrect lifestyle expectant mother, past infections, hypothermia. These processes contribute to development in the pregnant woman, which passes on to the fetus.

Hydronephrosis

This disease is caused by stagnation of urine in the calyces of the kidney. The process occurs as a result of abnormalities in the development of the ureter or lumen. These features are determined during examination of the fetus from the fourth month of intrauterine development. After birth, surgery may be required to normalize the functioning of the urinary organs.

Megaureter

The disease occurs in the presence of reflux (vesicoureteral). In this case, urine returns from Bladder. The cause is an abnormal development of the valve or underdevelopment nervous system baby. The optimal solution is surgery, as alternative treatment use special gels.

Multicystic

This disease occurs in the fetus under the influence of toxic substances taken by the mother or as a result genetic disorders. With this disease, a change in the structure of the kidney tissue occurs, and the organ is unable to perform its functions.

In the presence of a formation that does not exert pressure or interfere normal operation kidneys, the cyst is left and monitored. Otherwise it is required surgery.

Polycystic

The cause of the disease is disorders at the genetic level. At the same time, the kidneys cope with their functions. You can live with this disease, but it is possible that such a disorder can cause kidney failure. Severe abnormalities will require dialysis or a donor kidney transplant. With polycystic disease, it is important to adhere to healthy image life.

Violation of the structure of the organ

If there are anomalies that arose during the development of the fetus, as the child grows older, problems may arise in the functioning of the organ. Such disorders include duplication of the kidneys and ureter, horseshoe-shaped structure. For such changes, surgery is indicated; the optimal period is up to 1 year.

Acquired diseases

As children grow up, kidney pathologies are possible, which arise from various reasons.

Pyelonephritis

Characterized by inflammation that appears against the background of hypothermia or as a result past diseases. Sometimes it becomes a consequence of surgery performed on the urinary organs. If treated improperly, there is a risk of progression to chronic stage. If therapy is started immediately, the disease can be quickly cured. Antibiotics are most often used to get rid of inflammation.

Glomerulonephritis

Suffering glomerulus, responsible for filtering. The disease can occur in acute or chronic form. Develops as a result of previous diseases, such as streptococcal infection, tonsillitis, scarlet fever.

Cystic formations

If there are growths on the kidneys great value has their nature. Cysts are usually benign in nature, but there is a possibility of transition to a malignant form. Therefore, children with kidney cysts are seen by a doctor. The cause of the development of this disease is the proliferation of epithelial cells. If the growth increases in volume, surgery is required.

Dilated pelvis

It is a consequence of reflux, in which the reverse release of urine occurs. It may be the result of an abnormal structure of the organ’s vessels, which affects the structure of the kidney tissue.

Immediately after the baby is born, experts recommend performing an ultrasound of the kidneys. This allows you to identify violations at an early stage and make decisions about prevention. further development diseases.

Kidney failure

With such a pathology, the paired organ is not able to perform its functions. This contributes to disruption electrolyte balance, accumulates in the patient’s blood uric acid. Such a pathology can lead to organ failure, which entails the most severe consequences, even death. Therefore, such a disease cannot be ignored.

Arises renal failure against the background of pyelonephritis, abnormal structure of organs, occurs in a chronic form. Reason acute stage may be the influence of toxic substances, which occurs against the background of an overdose of medications.

Nephroptosis

It is caused by a structural anomaly in children, in which the kidney is not sufficiently fixed. The organ is mobile, can rotate around its axis, and with such movement the vessels suffer, which provokes disruption of normal blood circulation.

ICD

Appearance urolithiasis in children - the result of changes in water salt balance. Pathology occurs due to insufficient fluid intake or poor nutrition. Drink plenty of fluids allows the removal of salts and prevents the formation of stones. The disease also occurs against the background of insufficiency when mineral metabolism broken. It is treated by laser exposure or surgery.

Signs

Symptoms of kidney disease in children differ depending on the type and severity of the pathology. If developmental anomalies began during the gestation stage, deviations can be determined by the following signs:

increase abdominal cavity;
violation of urine color;
urination with reduced pressure;
low-grade fever;
vomit;
loose stool.

Kidney disease in newborns can cause yellowing of the skin as a result of metabolic disorders. Especially dangerous sign is the absence of urine - this is a reason for immediate hospitalization. Convulsions and restless behavior during deurinization also require medical attention.

Signs of kidney disease in older children may appear in a latent form, making early diagnosis difficult. But there are characteristic features that cannot be ignored:

painful urination;
changes in the composition and color of urine;
presence of “flakes”;
smell of acetone;
pain in the lower back and abdominal cavity.

In the presence of inflammation, an increase in temperature is observed. Children refuse to eat and have dry mouth. In the morning, swelling on the face is noticeable. Such symptoms in children are a reason to pass comprehensive examination.

Signs of kidney disease:

A pink tint to the urine indicates hematuria. This manifestation indicates possible development pyelonephritis, urolithiasis or injury to the urinary organs. Colored urine may indicate consumption of beets or grapefruit; such a change is not dangerous.
Swelling of the face and limbs may indicate kidney failure.
With rare urination and a small amount of fluid (anuria), chronic renal failure is possible.
Pale skin– a sign of glomerulonephritis.

Diagnostics

If any of the above symptoms appear, you should undergo thorough examination, including:

Ultrasound of organs urinary system;
urography;
blood and urine tests.

To establish a diagnosis for kidney problems in children, you need to contact a urologist or nephrologist.

Therapy

Treatment depends on the type of disease and is prescribed on an individual basis. Not always effective conservative methods treatment, in some cases the problem can only be solved surgically.

Drug therapy Kidney diseases in children include:

drugs to lower blood pressure;
antihistamines;
diuretics;
antibiotics.

In the presence of oncological formations, with urolithiasis, as well as with renal failure, surgical intervention is required.

Prevention

To avoid kidney disease in your child, you need to follow some rules. You should start with the diet; spicy, fried, salty foods create additional stress on the baby’s kidneys. It is worth diversifying your diet with calcium-rich dairy products and juices. This will not only improve kidney function, but also strengthen the body's defenses. Children should eat cereals, vegetables and fruits, and pumpkin.

It is very important to keep your lower back and legs warm and avoid hypothermia. At the same time, it is necessary to harden the child’s body and increase resistance to diseases. If there is an infection, follow your doctor's instructions. If a course of antibiotics is prescribed, you need to drink according to the schedule and until the end.

When warning signs should contact you immediately medical care. Kidney diseases in children cannot be treated on their own; this can lead to severe complications.

A big problem for parents and children's doctors is the diagnosis of diseases internal organs The child has. Is not infectious pathology, when the manifestations are obvious even to people far from medicine. Kidney diseases in children can be congenital or acquired. Diagnosis of pathologies of both groups is equally important, since in the end, without adequate correction, signs of insufficiency of renal function appear.

If in adolescence and pre-puberty it is not difficult to identify problems with urinary excretion, then in a newborn child this becomes a serious problem. Parents need to pay attention to the following symptoms:

increased fatigue and weakness;
decreased physical activity;
change in the frequency and frequency of urination;
a rise in temperature without other objective reasons;
the appearance of impurities in urine, changes in its color and transparency;
pain and discomfort in the lumbar region;
edematous syndrome with swelling around the eyes, in the face area;
thirst and dryness of the oral mucosa.

Symptoms of renal parenchyma disease are combined with changes in laboratory tests blood and urine. Therefore, paraclinical studies are prescribed to confirm the disease.

Attentive attitude to appearance and the behavior of children allows you to timely detect that the child is sick and conduct research on specific forms of pathology.

Signs in one-year-old children

Manifestations of pathology of the abdominal organs in the case of children are nonspecific and may resemble other diseases. U one year old child In case of inflammatory or obstructive kidney diseases, you need to pay attention to the warning symptoms:

lack of urination;
noticeable increase in abdominal size;
rise in temperature;
decreased appetite;
the appearance of cloudy or brown urine.

Children should be given maximum attention. If kidney disease in children is not diagnosed in time, the pathology can result in acute renal failure with uremia syndromes.

Jades

Most often, kidney diseases in children are inflammatory in nature. These include pyelonephritis and glomerulonephritis.

Pyelonephritis is observed in little girls much more often than in boys. This frequency is associated with anatomical features structure of the genital organs. In addition, parents often neglect hygiene recommendations. For this reason, pyelonephritis in girls early age called "pyelonephritis of poor care."

The main symptoms of inflammation in the pyelocaliceal system are dysuric disorders. This is pain when urinating, the appearance of urine brown color, change in the frequency of urination with a predominance at night. There are cases with clear signs of general intoxication syndrome. Then the disease manifests itself with fever, dehydration, and vomiting (sometimes uncontrollable). The appearance of febrile convulsions (fibrillary muscle twitching against the background of a rise in temperature) is possible.

Nephritis with damage to the glomerular apparatus of the kidneys suggests inflammation after a streptococcal infection. Second possible variant — chronic course pathology. With this disease, symptoms arise due to genetically determined mechanisms.

Swelling in the eye area comes first. In the evenings they subside, but in the morning and early morning hours their size increases. Second important symptom- hypertension. Children are diagnosed with high blood pressure at the appointment. IN Everyday life they feel it in the form of headaches, dizziness and decreased mental and physical activity.

Other diseases

Not only kidney inflammation in children can cause the complaints described above. Among other pathologies of the urinary system, urologists distinguish enuresis, urinary incontinence, and inflammation of the mucous membrane of the bladder.

Bedwetting is a disease that is diagnosed in early childhood. At night, the child involuntarily urinates. This disease is not considered renal. It is treated by pediatric neurologists or epileptologists.

Developmental anomalies are considered separately. There is a change in the structure of the renal tissue itself or pathological congenital change vessels. The first group of conditions includes polycystic disease, agenesis and renal hypoplasia. Polycystic transformation involves the appearance of several cysts in the renal parenchyma. There are two types of the disease - recessive and dominant. In the first case, manifestations of renal failure increase progressively, leading to terminal stage already by 1-2 years of life. Symptoms and treatment of this pathology are the responsibility of pediatric nephrologists, and, if necessary, transplantologists and replacement technology doctors.

The term "aplasia" means underdevelopment of the structure of an organ. In this case, not just the size of the kidneys decreases, but the number of functioning units - nephrons - decreases. Agenesis implies the absence of a kidney.

Position anomalies include various options dystopia, as well as prolapse or nephroptosis. It is no secret that kidneys change their location during their development. Initially, the fetal organs are located in the pelvic projection. But at a certain point in ontogenesis they find themselves in the retroperitoneal space. When this does not happen, dystopia is diagnosed. This is one of the risk factors for urinary tract infections.

Stage 1 nephroptosis is not considered a serious pathology. But patients with stages 2 and 3 prolapse may need help. This group of patients is more likely to experience inflammatory processes in the renal parenchyma. Frequent exacerbations can only be treated surgically.

How to confirm kidney tissue disease

Symptoms of damage to the nephrons or renal interstitium are nonspecific. That's why Clinical signs kidney disease needs to be supplemented with research.

It is worth finding out in detail from your local pediatrician how to check your kidneys. The basis for diagnosing diseases of the urinary structures, despite the development of imaging techniques, is laboratory research. This general analysis urine with organoleptic assessment, physical and chemical properties, microscopic characteristics. If borderline results are detected, the examination is supplemented with tests according to Nechiporenko and Zimnitsky. If bacteria are detected (the nitrate test is positive), a bacteriological analysis of the urine should be performed.

The next stage of the diagnostic search is the use of imaging techniques. This ultrasound examination, as well as tomography, radiography, urography. Each method has its own indications, contraindications, and preparation. In addition, each of them has advantages and disadvantages in a given situation. Therefore, it is extremely undesirable to go through them yourself, much less put children at risk.

Each specific clinical case is examined by a doctor, and the diagnostic scope is determined individually, taking into account all possible characteristics. Some situations will require nursing care.

The main organs of the urinary system are the kidneys. They filter the blood and cleanse it of foreign, toxic substances and drugs. The kidneys help maintain a constant water-salt composition of the blood, through them child's body The end products of metabolism and excess fluid are removed. Kidney disease in children is quite common.

Major kidney diseases in childhood

Glomerulonephritis

The inflammatory process in the kidneys can be acute or subacute, and can also be chronic.

Acute glomerulonephritis

It occurs most often after illnesses such as tonsillitis, scarlet fever or erysipelas, and maybe another infectious disease streptococcal nature.

Symptoms of the disease:

A few days after the infection, the baby becomes lethargic, has a headache, nausea and vomiting.
A feeling of thirst arises, swelling appears on the face - under the eyes, then on the legs and then throughout the body.
The urine becomes intensely red.
Blood pressure rises.

Treatment acute glomerulonephritis:

So that it doesn't happen serious complications, it is necessary to begin treatment as quickly as possible. Otherwise, acute renal failure is possible - the kidneys will no longer be able to function and filter urine. As a result, toxic products accumulate in the child’s body.

To cure kidney disease in children, a special diet is prescribed.

All products are prepared without salt.
Drinking is sharply limited.
Fruit-sugar, fruit-vegetable days are shown.
The diet should be expanded to include vegetables and flour dishes.
At the very beginning of the diet, limit the amount of protein consumed.
It is necessary to prescribe vitamins of all groups.

The main method of treating kidney disease in a child is antibiotic therapy.

Subacute glomerulonephritis

This disease can develop from acute glomerulonephritis. The disease is characterized by a rapid onset.

Symptoms:

Swelling occurs.
Urine output decreases.
Intensely bloody urine.
Blood pressure increases greatly.

The disease quickly leads to the development of chronic renal failure. The prognosis is extremely unfavorable. Only sometimes, with timely initiation and proper therapy, is it possible to prolong the child’s life and cure it.

Treatment is the same as for acute glomerulonephritis. In addition, hemodialysis is performed - an artificial kidney.

Chronic glomerulonephritis

The cause of its occurrence is not always due to infection. Presumably, the disease may be caused by genetic characteristics of the immune system. There are other possible reasons that contribute to the occurrence of primary chronic glomerulonephritis or the transition of acute glomerulonephritis to chronic.

Forms of chronic glomerulonephritis:

Nephrotic.
Mixed.
Hematuric.

Most common in children aged one to five years chronic glomerulonephritis nephrotic form.

Symptoms:

Edema.
Blood in the urine – hematuria.
Strong excretion of protein in the urine.
Decreased protein in the blood.
Blood pressure does not increase.
The child's skin becomes pale alabaster in color, cold and dry.
Dry mouth appears.
Thirst.
Weakness.
Cough, shortness of breath.
The pulse quickens.
The liver enlarges.
The amount of urine decreases.

The course of the disease is relapsing. Periods of exacerbation occur after subsiding a short time symptoms of the disease.

Mixed form

It affects mainly older children and is the most severe in nature.

Symptoms:

The child is lethargic and has a decreased appetite.
Pale skin.
Swelling of all tissues is observed.
Digestion is disrupted.
A headache appears.
Dizziness.
Sleep is disturbed.

Blood pressure increases moderately, and medications to lower it become ineffective. As a result, the left ventricle of the heart enlarges. This may be complicated by acute left gastric failure.

Kidney function is gradually impaired and chronic renal failure is formed.

Hematuric form

It manifests itself mainly as constant, persistent and severe hematuria - blood in the urine. In addition, protein is found in the urine - proteinuria. Occasionally blood pressure rises. There is almost no swelling. This form is more often observed in schoolchildren.

Treatment is similar to that for acute glomerulonephritis.

In the phase of chronic renal failure, hemodialysis is used, and kidney transplantation is also performed.

Pyelonephritis

This is an inflammation of the renal pelvis and calyces - the formations where urine flows from the medulla of the kidneys. Pyelonephritis can be acute or chronic.

Acute pyelonephritis

This disease occurs in a child as a result of microorganisms entering the kidneys. Most often it is Escherichia coli, but the disease can also be caused by other microorganisms - Proteus, staphylococcus and others. Pathogens can enter the kidney in three ways:

With blood flow
Through lymphatic vessels,
Through the urinary tract.

Babies in the first months of life are most often infected through blood. Older children are more likely to develop pyelonephritis, which develops from an infection urinary tract, and girls get sick more often than boys, since urethra theirs are shorter and wider. This makes it easier for pathogens to ascend to the kidneys.

The development of pyelonephritis is facilitated by any factors that impede the outflow of urine - kidney stones, kidney malformations.

Symptoms of the disease in newborns:

In newborns in the first months, the disease is especially severe.
Body temperature rises to thirty-eight to forty degrees.
Intoxication increases, vomiting and regurgitation appear.
Observed meningeal symptoms– the head is thrown back, the legs are bent at the knees.
The body becomes dehydrated.
The skin may turn yellow.

When urinating, the baby becomes restless and screams - this indicates that urination is painful.

Symptoms of the disease in older children:

In older children, the onset of the disease is not so acute. In addition, their pyelonephritis is usually preceded by bladder disease.
This is manifested by urinary incontinence and frequent urge to urinate with a small amount of urine, and a burning sensation when urinating.
Later, complaints of pain in the abdomen or lumbar region appear. If you lightly tap on the lumbar region with your fist, the pain increases sharply.

Complications of the disease:

Untreated or poorly treated pyelonephritis may cause complications.

Sepsis.
Kidney abscess.
Kidney carbuncle.
Inflammation of the perinephric tissue - paranephritis.
Transition of the disease into a chronic form.

Treatment of the disease:

Bed rest.
Peace.
Warmth on the kidney area.
Salt-restricted diet. With plenty of liquid.
Antibiotics taking into account sensitivity to them.

Chronic pyelonephritis

This disease develops as a result of an acute process. This is facilitated by factors leading to stagnation of urine, inflammation of the bladder, inflammatory diseases genital area in girls and a decrease in the body’s reactivity. Most often, both kidneys are affected.

Symptoms during exacerbation:

Fever.
Chills.
Frequent urination.
painful sensation when urinating.
Abdominal or lower back pain.
Headache.
Pallor.

Treatment is similar to that prescribed for acute pyelonephritis.

Nephrotic syndrome

This disease is a toxic-allergic kidney injury. It appears in the background intrauterine infection suffered from asphyxia during childbirth. You should add to this list congenital pathology kidneys and allergies.

Symptoms of the disease:

The disease begins gradually.
Fatigue.
Appetite decreases.
The baby becomes irritable.

Later, pallor of the skin and mucous membranes and swelling begin to attract attention. At first it is just pastiness of the face and legs, then the swelling intensifies and spreads throughout the body.

Fluid accumulations appear in the pleural and abdominal cavities.

The child complains of dry mouth and unpleasant taste.
Nausea.
Vomit.
Bloating.
Stomach upset.
Necessary measures for treatment
Bed rest.
Diet - salt in limited quantities, water consumption also needs to be reduced.
Glucocorticoid drugs - prednisolone for a couple or three months.
Heparin, diuretics, the child needs to be given vitamins.

In any case, only a doctor can prescribe correct treatment. Self-medication is unacceptable here. Therefore, if symptoms appear, it is necessary to urgently consult a specialist. He will hold necessary examination and make a diagnosis, on the basis of which it will be prescribed effective treatment child.

Sincerely,

How and what to feed and water a child with kidney disease? Does stress cause kidney disease in children? And can a baby “outgrow” kidney problems? Dmitry Ivanov, Honored Doctor of Ukraine, Professor, Doctor of Medical Sciences, Nephrologist, answers these and other questions highest category

- How to understand that a child has kidney problems?

Parents should be wary of such clinical manifestations: cloudy, uncharacteristically smelling, discolored urine, anemia, growth retardation, and in adolescents - increased blood pressure. Swelling, as the most striking sign of kidney problems, fortunately, is quite rare in children. It is worth considering that kidney diseases relatively rarely give clinical manifestations, so they can be identified during a clinical examination.

It is advisable to take a general urine and blood test at least once a year, and do an ultrasound of the internal organs, including the kidneys. This will allow the disease to be identified in time and successfully treated, since if the problem is detected late, treatment options are often exhausted. If there are any changes characteristic of kidney disease, the doctor will draw the parents’ attention to this and send the child for further examination. Usually we are talking about three groups of the most frequent illnesses kidney infections in children urinary system(pyelonephritis, cystitis), glomerulonephritis and various functional disorders, For example, dismetabolic nephropathy.

Are today's children increasingly suffering from kidney disease? Are these diseases related to the quality of food, water, the environmental situation, or taking medications?

It cannot be said that children are getting sick more often. Pyelonephritis or cystitis are infections that have always been in second or third place among infections childhood. On the first - bronchopulmonary, on the second in the summer - intestinal infections, and in winter - just infections of the urinary system. Diagnostics and alertness on the part of doctors have also improved, and the level of knowledge of parents has increased, which is why these infections are detected more often. On the contrary, in our country (as well as abroad) people are suffering from glomerulonephritis less often, that is, in general, I would not say that now children are getting sick more often than before. Therefore, I would not associate kidney disease with the quality of food, the environment, taking medications, or the quality of water. You just need to understand that humanity is susceptible to infections, including those of the urinary system. And if we detect them in time, then, as a rule, we successfully treat them.

- Does the use of diapers affect the health of children's kidneys?

If you change diapers on time, then no. What's the difference - diapers or diapers? The whole question is how often the mother changes a wet diaper and how carefully she cares for the child.

What do you think about the point of view of Vedic medicine that kidney disease in children is associated with a lack of mother's love?

I think that the lack of maternal love is associated not only with kidney disease, but in general with the suffering that the child experiences. Therefore, I really want a mother to love each of her children, even when he becomes an adult.

- Can stress, fears, mental disorders cause kidney disease in children?

I find it difficult to assess this in children. But I can say, judging by adults: fear provokes a stress reaction, due to which vasoconstriction occurs. And the kidneys, as you know, are the most blood-supplied organ, so vasoconstriction and changes blood pressure primarily affect functional state kidney It is choleric people and people with high blood pressure get sick more often kidney diseases. Extrapolating these observations to adults, it can theoretically be assumed that stress or strong experience may well serve as an impetus for kidney disease, although children are softer, more labile, and flexible.

- Is the formation of salts and kidney stones related to the fact that the child was breastfed or artificially fed?

Nowadays baby food formulas are of such quality that it seems incorrect to me to say that they lead to the development of urolithiasis. Urolithiasis is, as a rule, a genetically determined metabolic disorder. But the trigger factor can be both diet and drinking water. That is, if a child has a more or less varied diet, this cannot be the cause of urolithiasis. Of course, some substances, for example, wood palm oil, can negatively affect the condition of the body, including the kidneys. But it is now impossible to say that this has been reliably established, since there is not yet enough data for this statement.

- What is the reason for the formation of salts in the kidneys in young children?

The reasons, as a rule, are genetic, due to the presence of salt balance disorders in children or imperfection renal functions. Today, every third child has increased excretion of phosphates or urates in the urine. But at the same time, urolithiasis is observed in 2.5-5% of the population, and 30% have salts. So the reason for the formation of salts in children is, most often, imperfect functioning of the kidney tissue or characteristics of the child’s body, which often disappear either with age, or with the correct influence from the doctor and careful parental care.

- What foods should not be consumed by children with kidney disease?

Strict diets for children, as a rule, are not prescribed, due to the fact that a child is a growing organism. Based on an analysis of the daily salt excretion, the doctor builds the correct diet. Advises which products to give preference to - dairy or meat, for example. Stick to a strict diet or go on a mineral water- nephrologists usually do not use such tactics for treating children.

And definitely for children, those foods that are not appropriate for their age are prohibited: smoked sausage, sorrel, nuts or strawberries in unlimited quantities. Children should eat according to their age and in moderation. In a word, the diet should be varied, then the risks of kidney disease will decrease. For example, a child can eat green borscht once every two weeks. But if you eat this dish for three days, oxalates may appear because it contains a lot of oxalic acid. But no one feeds a child green borscht for so many days in a row!

- How to feed a child correctly if there are kidney problems? What products are definitely prohibited?

Since the problems are varied, the recommendations regarding nutrition are completely different. For example, if the diagnosis is glomerulonephritis, there will be some restrictions, if salts - other restrictions, if pyelonephritis - still others. But there are no strict restrictions.

Nephrologists advise feeding the child dietary nutrition according to the age. Strict restrictions and diets are introduced in case of impaired renal function, renal failure, massive excretion of salts, when dysmetabolic nephropathy occurs, preceding urolithiasis. Basically, there is no point in talking about strict prohibitions in baby food, but rather about pediatric rules. After all, we, as a rule, do not go to extremes - we do not feed the child only lard or milk, we do not allow the baby to eat a plate of dumplings at a time. And not because the kidneys don’t allow it, but because eating this way is fundamentally wrong.

- Can children with kidney problems play sports? Are there any restrictions?

It depends on what disease the child has. But nephrologists do not object to recreational sports activities. Stories when children are trained to become champions must be considered individually, then there are limitations. If we are talking about sport as a general developmental activity, then I would not talk about any strict prohibitions. Limit exercise if there are abnormalities in the development of the kidneys or kidney failure, as well as complications arising from kidney failure.

- Tell me, what is the difference between the work of a pediatric nephrologist and a pediatric urologist?

A urologist is a surgeon, and a nephrologist is, in other words, a therapist. All those diseases that can be treated without surgery are dealt with by a nephrologist. Where surgical intervention is the main element of treatment, a urologist is needed.

- Do children have stones removed? Which methods of removal and crushing are preferable?

Yes, stones are removed. There are various tactics, including minimally invasive ones. You can enter the kidney and crush the stones, or you can surgically remove the stone. Of course, it is more difficult to perform operations on children, but such techniques exist. By the way, technology abroad makes it possible to perform similar operations even in utero in order to eliminate pathology in the embryo.

- Do children outgrow kidney problems?

Yes, they outgrow, fortunately. After all, kidney tissue begins to function like an adult’s at the age of 18. There are also certain stages in the development of functions: the filtration function matures by 2 years, the concentration function - by 12 years, the function of maintaining red blood cells - up to 1 year, the function of maintaining acid-base balance - by 10 years, the function of full synthesis of vitamin D - by 2 years, function of blood pressure regulation - by the age of 18. This is why children with vegetative-vascular dystonia The kidneys are considered as the element responsible for the formation of blood pressure levels.