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Glomerulonephritis nephrotic syndrome in children prognosis of recovery. Acute and chronic glomerulonephritis in children: symptoms, diagnosis, treatment

Glomerulonephritis is rightfully considered one of the most common and dangerous kidney diseases in children. This disease requires especially careful attention on the part of parents and doctors, because in case of untimely provision of assistance or improper treatment, complications can be fatal for the child. You will learn more about this disease and what the correct actions should be during treatment in this article.

The disease and its varieties

Glomerulonephritis- a disease that affects special kidney cells - glomeruli, which are also called glomeruli. Small cells gave the disease its second name - glomerular nephritis. Because of this, the kidneys cease to fully perform their functions. This paired organ is entrusted by nature with many concerns - the removal of decay products, toxins from the body, the production of substances that control blood pressure and erythropoietin, which is simply necessary for the formation of red blood cells in the blood. Malfunctions of the kidneys lead to the most tragic consequences.

A child with glomerulonephritis has a huge amount of protein in the urine, along with red blood cells (blood in the urine). Thus, anemia, arterial hypertension, edema develops, and immunity is reduced due to protein losses that are catastrophic by the body’s standards. Due to the fact that the lesion progresses differently, and the reasons why the glomeruli of the kidneys begin to die are very heterogeneous, the disease in pediatrics is not considered a single disease. This is a whole group of kidney diseases.

Most often, glomerulonephritis affects children aged 3 to 10 years. Children under 2 years of age get sick much less often; only 5% of all cases occur in them. Boys get sick more often than girls.

The classification of glomerulophritis is quite complex and is based on symptoms and clinical picture.

All glomerular nephritis are:

primary(if kidney pathology manifested itself as a separate independent disease);
secondary(kidney problems began as a complication after a severe infection).

According to the characteristics of the course, two large groups of the disease are distinguished:

spicy;
chronic.

Acute glomerulonephritis is expressed by nephritic (sudden, sharp) and nephrotic (gradually and slowly developing) syndromes; it can be combined and isolated (when there are only changes in the urine, without other symptoms). Chronic can be nephrotic, hematuric (with the appearance of blood in the urine) and mixed.

Diffuse chronic glomerulonephritis develops slowly and gradually, most often the changes in the body are so insignificant that it is very difficult to determine later when the pathological process leading to the death of kidney cells began. Depending on the type of pathogen that caused the underlying disease, complicated by glomerulonephritis, several types of disease are distinguished, the cause of which becomes clear from the name - post-streptococcal, post-infectious, etc.

And based on the severity of the symptoms and the damage that has already been caused to the kidneys, doctors conditionally assign each case 1,2 or 3 degrees, with an obligatory indication of the stage of development of the disease (for a chronic illness).

Reasons

The kidneys themselves are not affected by pathogenic microbes and other “outside invaders”. The destructive process is triggered by the child’s own immunity, which reacts to a certain allergen. Most often, streptococci act as “provocateurs”.

Glomerulonephritis is often a secondary complication of primary streptococcal tonsillitis, bacterial pharyngitis, scarlet fever.

Less commonly, the death of renal glomeruli is associated with influenza, ARVI, measles, and hepatitis viruses. Sometimes the allergens that trigger the destruction of glomeruli are snake or bee venom. For reasons that are not yet entirely clear to science, the body, instead of simply bringing these harmful factors out, creates against them a whole “heavy artillery” of the immune complex, which hits its own filters - the kidneys. According to doctors, such an inadequate reaction of the body is influenced by factors that at first glance have little influence - stress, fatigue, climate change, place of residence, hypothermia and even overheating in the sun.

Possible complications

Glomerulonephritis is considered a serious disease. It is quite complex in itself and is rarely completely cured. The most predictable and expected complication of an acute illness is its transition to a chronic diffuse form. By the way, about 50% of all cases are complicated this way.

But there are other complications that pose a danger to life or can cause disability:

acute renal failure (occurs in approximately 1-2% of patients);
heart failure, including its acute, deadly forms (3-4% of patients);

cerebral hemorrhage;
acute visual impairment;

kidney dysplasia (when the organ begins to lag behind in growth rates from the size required by age, decreases).

Changes in the kidneys can be so significant that the child will develop chronic renal failure, in which case an organ transplant will be indicated.

With kidney transplantation in Russia, everything is quite deplorable; the child may simply not wait for the donor organ he needs. An alternative (temporary) is an artificial kidney. Since the procedures should be carried out several times a week, the baby becomes dependent on the device, because he simply has no other way to cleanse the body of toxins.

Symptoms and signs

Usually, 1-3 weeks after an illness (scarlet fever or tonsillitis), the first symptoms of glomerulonephritis may appear. The most striking sign is change in urine color. It turns red in a child, and the shade can be either bright or dirty, which is usually called the “color of meat slop.”

The beginning of acute nephritic glomerulonephritis in a child can also be recognized by swelling on the face, which looks like dense, full, changing little during the day. Blood pressure increases, which may result in vomiting and severe headaches. This form of the disease has the most positive prognosis, since more than 90% of children experience a complete recovery with adequate treatment. For others, the disease becomes chronic.

Acute nephrotic disease“attacks” from afar, symptoms appear gradually, due to this the child has no complaints for a long time. If parents do not ignore the morning swelling, which sometimes disappears completely during the day, and go with the child to give urine, then sure signs of the disease will be found in it - proteins.

The first swelling begins to appear on the legs, then gradually spreads further - to the arms, face, lower back, and sometimes to internal organs. The swelling is not dense, it is looser. The child's skin becomes dry, and the hair becomes brittle and lifeless. At the same time, blood pressure rarely rises, and the urine has a normal color, since the protein in it does not color the liquid in any way. For this type of disease, the prognosis is not rosy: according to doctors, only 5-6% of children recover, the rest continue to be treated, but for a chronic form.

If a child’s urine changes color (becomes redder), but there are no other symptoms or complaints, nothing swells or hurts, then we may be talking about isolated acute glomerulonephritis.

About half of all young patients can be cured from it if they go to the hospital in a timely manner. The remaining 50%, even with proper treatment, for logically inexplicable reasons, begin to suffer from a chronic disease.

If a child has all the signs of all three described types of the disease, then we can talk about a mixed form. It almost always ends in transition to a chronic disease and the prognosis is unfavorable. The likelihood of recovery is influenced by the state of the immune system. If it is weak or there is some defect in it, then the onset of the chronic form becomes more obvious.

With chronic glomerulonephritis, the child experiences periods of exacerbation with swelling and changes in urine and periods of remission, when it seems that the disease is left behind. With proper treatment, only half of patients achieve stabilization. About a third of children develop a progressive process, and this ultimately often leads to an artificial kidney.

Hematuric chronic pyelonephritis is considered the most favorable among chronic varieties of the disease. It does not lead to the death of a person, and is noticeable only during periods of exacerbation, when of all the signs the only one appears - blood in the urine.

Diagnostics

If a child has noticeable swelling, even if only in the morning, even if only on the legs or arms, this is already a reason to contact a nephrologist. If the urine has changed color, you need to go to the clinic urgently. Parents should remember that analysis of urine that has been in a jar for more than an hour and a half is less reliable, so you need to use all possible means to deliver the collected urine to the laboratory during this time.

Diagnosis of glomerulonephritis includes a visual examination of the child and laboratory tests, the main of which is the urine test. The number of red blood cells in it will be determined, and the quality - whether they are fresh or leached. An equally important indicator is protein in the urine. The more it is released, the more severe the stage of the disease is usually. In addition, the laboratory assistant will indicate a couple of dozen more different substances, salts, acids, which can tell the nephrologist a lot.

Usually this is enough, but for small children and with very poor tests, doctors “play it safe” by prescribing Ultrasound examination of the kidneys. In doubtful situations, a kidney biopsy may also be prescribed. The doctor recognizes a disease as chronic if the symptoms have lasted for more than six months or if changes in urine formulas have remained at abnormal values for more than a year.

Treatment

In case of acute glomerulonephritis, home treatment is strictly contraindicated.

The doctor will strongly recommend going to the hospital and this is quite justified. After all, the child needs complete rest and strict bed rest. The patient is immediately prescribed diet No. 7, which does not include salt, significantly limits the amount of liquid drunk per day, and cuts the amount of protein food by approximately half of the age norm.

If the disease is caused by streptococci, then a course of penicillin antibiotics is prescribed. In a hospital setting, they will most likely be injected intramuscularly. To reduce edema, diuretics are prescribed in a strict age-specific dosage. If you have high blood pressure, you will be given medications that can lower it.

The modern approach to the treatment of glomerulonephritis involves the use of hormones, in particular “Prednisolone” in combination with cytostatic drugs that can stop and slow down cell growth. Such drugs are usually widely used in the treatment of cancer, but this fact should not frighten parents. When the condition of the kidneys improves, they are entrusted with the function of slowing down the growth of immune colonies, and this will only benefit the suffering kidney cells.

If a child has concomitant chronic infectious diseases, after the acute stage of glomerulonephritis, it is strongly recommended to eliminate foci of infection - cure all teeth, remove adenoids if they hurt, undergo a course of treatment for chronic tonsillitis, etc.

But this should be done no earlier than six months after suffering an acute kidney disease or exacerbation of a chronic one. Recovery, if the treatment schedule is followed, usually occurs after 3-4 weeks. Then the child is recommended to study at home for six months to a year, to be registered with a nephrologist for at least two years, to visit sanatoriums that specialize in kidney diseases, and to follow a strict diet. Such a child cannot receive any vaccinations for a year. And with every sneeze and the slightest sign of ARVI, parents urgently need to take his urine samples to the clinic.

Chronic glomerulonephritis is treated in the same way as acute glomerulonephritis, since it requires treatment only during periods of exacerbation.

With it, you should also not insist on home treatment; the child must be hospitalized, because in addition to therapy, there he will undergo a full course of examination to find out whether the disease has begun to progress. In severe forms and extensive destruction of kidney structures, artificial kidney procedures and transplantation of a donor organ to replace the affected one are indicated.

A child with a chronic illness will be registered at a dispensary for life. Once a month he will need to have a urine test, visit a doctor, and have an ECG done once a year to prevent pathological changes in the heart.

Prevention

There is no vaccine against this serious disease, and therefore prevention is not specific. However, parents should know that no sore throat or pharyngitis should be treated without permission, because the disease may turn out to be streptococcal, and without antibiotics or if they are taken uncontrolled, the likelihood of such a complication as glomerulonephritis will increase significantly.

After suffering from scarlet fever, you should definitely take a urine test 3 weeks later, even if the doctor forgot to prescribe it for you. 10 days after streptococcal tonsillitis or streptoderma, you must also take urine samples to the laboratory. If there is nothing alarming about them, then you don’t have to worry. Prevention of kidney diseases in general and glomerulonephritis in particular includes proper treatment for ARVI, vaccination against influenza, and measles. It is important to ensure that the child does not sit on the cold floor with his bare bottom and does not overheat in the sun in the summer.

For more information about diagnosing this disease, see the following video.

Illness is always bad, but the worst thing is if it plagues your child. Parents would give everything in the world so that their child would not be in danger. Of course, there are diseases that come and go: colds, flu, and so on. But there are also those who stay with the baby for a long time, and among them glomerulonephritis in children occupies a special place.

What is it

Glomerulonephritis is a bilateral kidney disease. The nature of its occurrence is infectious-allergic. First, the glomeruli of the organ are affected. Over time, all kidney tissue and other systems of the child’s body are affected. Metabolic processes are disrupted.

Most often, this disease manifests itself between the ages of five and twenty years. Almost never occurs in newborns.

The development of the disease is influenced by living and nutritional conditions, the reactivity of the body, and what infections the child has had. Sometimes the disease begins to develop on the second day of the appearance of any infection. The acute form of glomerulonephritis occurs more often in boys.

The disease glomerulonephritis has its own negative features:

According to the clinical course, the following forms occur:

acute;
subacute;
chronic.

According to the extent of the lesion, glomerulonephritis in children is divided into:

diffuse;
focal.

By location of the lesion:

in the glomerulus - intracapillary;
inside the glomerular capsule - extracapillary.

According to the nature of the inflammatory process:

exudative;
proliferative;
mixed.

As you can see, the forms of glomerulonephritis in children can be different, and they depend on many factors.

Now let's talk about some of them in more detail.

Acute form of the disease

Most often it is caused by streptococci, sometimes staphylococci or pneumococci. It proceeds violently, the symptoms are pronounced, and responds well to treatment. True, it should be said that there is also a latent course of the disease. The symptoms are almost invisible and very difficult to detect. It is at this moment that the disease has every chance of developing into a chronic stage.

Acute glomerulonephritis in children is considered rapidly progressive. All pathological processes in the kidneys disappear instantly. This can lead to kidney failure, leading to the need for hemodialysis or a kidney transplant.

Treatment of this form of glomerulonephritis is carried out only in hospital settings. The child is prescribed bed rest until his condition begins to improve. If the treatment process is not started in time, unpleasant consequences may arise, one of which is, as mentioned above, the transition of the disease to a chronic form.

Symptoms of the acute stage of the disease

Usually they begin to be detected within a week or two after an infectious disease. They appear in the following form:

the child’s general condition worsens;
weakness appears;
appetite decreases.

A few days later:

the lower back begins to hurt;
the temperature rises;
the skin becomes pale;
swelling appears (first in the morning, near the eyes; over time, the limbs also become swollen);
the amount of urine excreted decreases; if the condition is very severe, the patient may completely stop going to the toilet;
urine has an unnatural color (from pink to dark red, sometimes there is a green tint);
your head starts to hurt;
nausea appears;
blood pressure rises.

All these signs signal kidney disease. The symptoms of adults and children are almost the same. The only point is that in the latter they are much more pronounced.

Clinical forms of the acute stage of the disease

During an illness, a set of symptoms with the same pathogenesis is always studied. Glomerulonephritis is no exception. Syndromes that can be distinguished by clinical forms are as follows:

nephritic;
nephrotic;
isolated;
mixed.

The first most often affects children aged five to ten years. The disease begins to develop a week after the child becomes ill with ARVI or another infectious disease. In this case, all processes occur very acutely:

The face swells. With proper treatment, this symptom goes away within two weeks.
Blood pressure increases, which is accompanied by nausea, vomiting, and headache. The condition may normalize within a few weeks, if the diagnosis is correct and appropriate treatment is made.
The composition of urine changes. This situation persists for several months.

Full recovery occurs in two to four months.

The nephrotic form is dangerous and severe. The forecasts are not reassuring. Only five percent of those sick can recover. For the rest, the acute form becomes chronic.

Acute glomerulonephritis symptoms in children have the following:

Swelling increases slowly.
The skin becomes pale.
Hair is brittle.
The amount of urine decreases sharply.
The amount of protein increases.
No red blood cells or white blood cells.

Isolated urinary syndrome is characterized only by changes in the child’s urine. There are no other symptoms. With this form, half of the patients are cured, and in the other half the acute stage becomes chronic.

In the mixed form, children experience all of the above symptoms. Prognosis - the acute form most often becomes chronic.

Chronic form of the disease

Chronic glomerulonephritis in children is a primary chronic disease and can be detected at any age. Sometimes it can be a consequence of untreated acute nephritis.

Pediatric chronic glomerulonephritis is classified as follows:

Nephrotic.
Hematuric.
Mixed.

From a morphological point of view:

Focal segmental sclerosis.
Minimal changes in the glomeruli.
Mesangioproliferative.
Membranous.
Fibroplastic.
Mesangiocapillary.

By pathogenesis:

Caused by immune processes (immune complex and autoantibody).
Not caused by immune processes.

Causes of the disease

Treatment of glomerulonephritis in children largely depends on the cause of the disease and its form. What contributes to the development of the disease?

The kidney cannot cope with the function of removing all toxic substances in the urine. It almost does not filter the blood, the glomeruli begin to die, the kidney becomes small and dry. The cause of the pathology is often:

untreated infectious diseases;
improper treatment;
hereditary predisposition.

Kidney disease is not caused by the infection itself, but by the body's response to this infection, its immune reaction. This is why most often the disease begins to progress after:

tonsillitis;
scarlet fever;
measles;
pneumonia;
chronic tonsillitis;
flu

Glomerulonephritis in children can be provoked by:

consumption of allergens;
severe hypothermia;
contact with toxic substances;
use of certain drugs (mercury, antibiotics, sulfonamides);
graft;
long exposure to the sun.

Diagnosis of the disease

The article is about children, but adults can also develop glomerulonephritis: the symptoms and treatment for both are largely similar. But there is one difference - children recover faster.

Before you begin the fight for the recovery of a person, no matter what age he is, it is necessary to make a correct diagnosis.

A general urine test is given. The presence of: red blood cells, white blood cells, casts, protein is determined.
The specific gravity of urine is determined.
The blood is checked for an increase in the titer of antibodies to streptococcus.
Total protein content.

This is about analysis. Second stage of diagnosis:

Radioisotope angiorenography.
Fundus examination.
Kidney biopsy. This procedure allows you to see the activity of the disease and makes it possible to exclude kidney disease, which has similar symptoms to chronic glomerulonephritis.

From the patient's first visit to a medical institution, the medical history begins. Glomerulonephritis is no exception. And how long this story will last depends on the correct diagnosis.

The first step to recovery

Treatment of glomerulonephritis in children involves hospitalization in a specialized department. They are prescribed bed rest and a mandatory diet. Fats and carbohydrates are consumed within the limits of physiological needs, and the amount of proteins must be limited. You will have to adhere to a strictly protein-free diet until azotemia and oliguria disappear. The amount of salt is also reduced. This happens until the swelling subsides.

Excluded: meat, fish, mushroom broths, smoked meats, sausages, cheeses, pickled vegetables, canned foods.

On the second or third day of illness, you can have a sugar-fruit day.

Bed rest must be maintained until signs of disease activity disappear. This period lasts about six weeks. After this time, the child can rise, even if he still has moderate microscopic hematuria.

This is the first step of treatment: diet and bed rest.

Treatment with drugs

As mentioned above, with a disease such as glomerulonephritis, the symptoms and treatment in children and adults are completely the same.

The fight against infection begins with the use of penicillin drugs.
Warming the renal area helps in the treatment of anuria.
For azotemia and hyperkalemia, if this condition lasts more than six days, peritoneal dialysis or hemodialysis is used.
With exacerbation of chronic glomerulonephritis with minimal changes in the glomeruli, cytostatics and glucocorticoids are used for treatment.
The drug Prednisolone is prescribed. One milligram per kilogram of weight is administered for six or eight weeks, then the dose is rapidly reduced to five milligrams per week.
If the activity of CGN is high, Prednisolone is used, but already by drip (three days, once a day). After treatment, it is advisable to carry out such pulse therapy at least once a month.
Cytostatic agents are prescribed intramuscularly: the medications “Cyclophosphamide” and “Chlorambucil”.
Alternative drugs used during treatment: drugs "Cyclosporine" and "Azathioprine". They are prescribed in cases where there is a high risk of renal failure.

Multicomponent treatment regimens

When diagnosed with glomerulonephritis in children, a multicomponent treatment regimen is used. The use of cytostatics and glucocorticoids simultaneously is considered much more effective than the use of glucocorticoids alone for treatment.

Immunosuppressive drugs are prescribed in combination with anticoagulants and antiplatelet agents.

Three-component scheme: two to three months - Prednisolone plus Heparin; then - the drug "Acetylsalicylic acid" plus the drug "Dipyridamole".
Four-component scheme: the drug “Prednisolone” plus the drug “Cyclofamide” plus the drug “Heparin”; then - the drug "Acetylsalicylic acid" plus the drug "Dipyridamole".
Ponticelli's regimen: Prednisolone for three days, Chlorambucil for the second month, and then alternating these drugs.
Stenberg scheme: pulse therapy is used. Over the course of a year, a thousand milligrams of the drug Cyclophosphamide are injected intramuscularly every month. For the next two years, the procedure is carried out once every three months. Another two years - once every six months.

Dispensary observation

In acute forms of the disease, after discharge from the hospital, it is advisable to transfer the child to a sanatorium. During the first three months, a general urine test is taken and blood pressure is measured. The doctor conducts an examination once every two weeks.

For the next nine months, the above procedures are carried out once a month. Then, for two years, you will have to visit the doctor once every three months.

It is mandatory to take a general urine test for any infectious disease, for ARVI and others.

The child is exempt from all physical activity and vaccinations.

It is removed from the register only if there have been no exacerbations or deteriorations for five years, and the tests were within normal limits. In this case, the child is considered to have recovered.

In the chronic form of the disease, the small patient is observed by a pediatrician before transferring to an adult clinic. Once a month, a general urine test is taken and blood pressure is measured.

Electrocardiography is performed every year.

Urine analysis according to Zimnitsky - once every two months. Herbal medicine one month at a time, every other month.

At this time, a diet must be followed, no hypothermia, sudden climate change, no stress. At the first symptoms of an infectious disease, you should immediately consult a doctor.

Conclusion

Prevention of the disease acute glomerulonephritis - diagnosis of any infectious disease, which must be carried out in a timely manner. If you immediately begin treating tonsillitis, scarlet fever and other diseases, you can avoid kidney disease. In addition, the child’s body should be hardened and strengthened.

And you should also teach your baby to eat the “right” food from an early age. After all, nutrition is one of the factors, perhaps even the most important, that is responsible for the health of both children and adults.

By combining all of the above, you can ward off an illness called glomerulonephritis from your child. So, if not everything, then a lot is in your hands, especially the health of your children.

Glomerulonephritis in children is an inflammation of the kidney glomeruli. The disease occurs in acute or chronic form and develops under the influence of infection or allergy. The disease is diagnosed based on characteristic signs, based on laboratory and instrumental studies. In severe cases of the disease, a gentle regimen, a special diet and medication are indicated.

Work of a paired organ

The kidneys perform essential functions. The main purpose is filtration and removal of metabolic products. The paired organ is responsible for the normal content of protein and carbohydrates, the generation of blood components, and maintains blood pressure at an optimal level. The kidneys are also responsible for the concentration of electrolytes and acid-base balance. The organ promotes the release of active substances and enzymes and regulates blood circulation.

Clinical picture

The inflammatory process in the glomeruli of the paired organ leads to a decrease in their performance. Glomerulonephritis occurs quite often in children and ranks second after infectious pathologies of the urinary system.

The disease affects children from 3 to 9 years of age; cases of the disease are less common in children under two years of age. Boys are most often affected by the pathology.

The cause of the development of glomerulonephritis in children is an allergy of an infectious nature, in which immune complexes are formed that circulate in the kidneys. The provoking factor may be the production of autoantibodies, which contributes to the development of autoallergy. Sometimes the disease becomes a consequence of metabolic disorders and hemodynamic changes, which leads to damage to the organ of a non-immune nature.

During inflammation, the tubules and interstitial tissues are affected. Glomerulonephritis is quite dangerous and can cause kidney failure, which leads to disability at an early age.

Reasons

The causative agents of glomerulonephritis are bacteria:

group A streptococci;
enterococci;
pneumococci;
staphylococci.

Among viral infections, the following have a negative effect on the paired organ:

chickenpox;
rubella;
hepatitis B;
measles.

The presence of harmful microorganisms can be a provoking factor in the development of pathology:

candida;
toxoplasma.

Among the non-infectious causes are allergens that can cause glomerulonephritis:

medications;
vaccines;
plants;
toxic substances.

The most common factor in the development of pathology is a previous streptococcal infection, tonsillitis, streptoderma, pharyngitis, scarlet fever.

The transition to a chronic form is the result of an untreated disease at the acute stage. The immune response to the presence of antigens plays a decisive role in the development of glomerulonephritis in children. The individual reaction of the body forms immune complexes, which have a negative effect on blood circulation in the kidneys and cause dystrophic changes.

The disease can develop in children susceptible to the following pathologies:

endocarditis;
rheumatism;
lupus erythematosus (systemic);
hemorrhagic vasculitis.

The disorder occurs in children with hereditary anomalies:

deficiency of C6 and C7;
T cell dysfunction.

Children with severe heredity, susceptibility to streptococci, and those suffering from chronic skin infections are predisposed to the disease. Glomerulonephritis develops in children and after suffering from acute respiratory viral infection or hypothermia. This disease occurs due to immunopathological reactions and immature kidneys.

Types of pathology

Glomerulonephritis occurs:

primary;
secondary (due to the development of other pathologies).

According to the clinical course, the disease is divided into:

spicy;
subacute;
chronic.

Taking into account the nature of inflammation, the following classification is carried out:

proliferative;
exudative;
mixed.

According to the degree of spread of the pathology:

focal;
diffuse.

By localization:

extracapillary;
intracapillary.

Taking into account the most pronounced manifestations, the following forms of glomerulonephritis are distinguished:

latent;
nephrotic;
hematuric;
hypertensive;
mixed.

Symptoms and treatment of glomerulonephritis depend on the form and severity of the disease.

Acute form

The following symptoms are characteristic of this pathology:

malaise;
increased body temperature;
headache;
feverish condition;
pain in the kidney area;
nausea, urge to vomit.

With the disease, urine output decreases, with the development of hematuria, and the urine turns reddish. With glomerulonephritis, swelling occurs, which is pronounced on the face, especially in the eyelid area. Body weight may increase by several kilograms due to insufficient removal of fluid from the body. The child's blood pressure rises sharply, which can last for quite a long time.

With proper treatment, it is possible to restore kidney function after glomerulonephritis within three months. With ineffective therapy or lack thereof, the disease becomes latent.

Chronic form

Glomerulonephritis in children can occur in a latent form, with relapses or increasing progression. There is microhematuria, which intensifies with exacerbation of the disease. Swelling is weak or completely absent, blood pressure is normal. Due to the scanty symptoms, glomerulonephritis in a latent form can be detected during examination of the child. Chronic pathology is diagnosed if signs of the disease persist for 6 months, and swelling and high blood pressure do not go away with treatment for a year.

Nephrotic syndrome is characterized by relapses. Symptoms of glomerulonephritis in children with a similar course of the disease are as follows:

decrease in urine volume;
severe swelling;
accumulation of fluid in the pleural or abdominal cavity.

At the same time, blood pressure remains normal, an elevated concentration of protein is observed in the urine, and red blood cells are present in small quantities. The content of nitrogen derivatives in the blood increases and the filtration function of the kidneys decreases with the development of chronic renal failure.

Diagnostics

The child's medical history is of great importance in establishing a diagnosis and determining the etiology. A thorough examination is carried out regarding hereditary pathologies, congenital anomalies, and previous infections. In case of glomerulonephritis, it is necessary to undergo the following studies:

urine and blood analysis (general and biochemical);
according to Nechiporenko;
samples of Zimnitsky and Reberg.

Ultrasound shows noticeable enlargement of the kidneys and increased echogenicity. As an additional diagnostic method, a biopsy of a paired organ is prescribed, which allows one to assess the prognosis and determine the method of treatment.

Therapy

With acute symptoms of the disease, treatment of glomerulonephritis in children requires hospitalization. It is important to maintain bed rest and adhere to a special menu. It is necessary to completely eliminate the consumption of salt-containing foods and reduce protein-containing foods to a minimum until the kidney function is completely restored.

At the acute stage of glomerulonephritis, antibiotic treatment is prescribed:

ampicillin;
penicillin;
erythromycin.

To reduce swelling use:

furosemide;
spironolactone.

Antihypertensive drugs are prescribed:

volsartan;
losartan;
nifedipine;
enalapril.

It is possible to treat chronic glomerulonephritis:

prednisone;
levamisole;
chlorobutine;
cyclophosphamide.

To prevent the formation of blood clots in children, Heparin is prescribed. If there is a strong increase in urea, uric acid, or creatinine with a pronounced reaction on the skin, the child may require hemodialysis.

Medical examination after illness

After completing the full course of therapy, the child is observed for five years. If glomerulonephritis recurs, the patient is placed on lifelong dispensary registration.

In case of acute form of glomerulonephritis in children, after hospital treatment, transfer to a sanatorium for recovery is required. In the first three months, blood pressure control is necessary, you should regularly take a urine test, and visit a doctor at least once every 14 days. After this period, visits to the doctor are made once a month throughout the year.

Children who have had glomerulonephritis are exempt from physical education and vaccinations are prohibited for 12 months. You should refrain from swimming in open water.

Prevention and prognosis

About 98% of children with acute glomerulonephritis make a full recovery. Quite rarely, pathology transforms into a chronic stage. In medical practice, there are cases of death due to this disease.

Glomerulonephritis in children is dangerous due to the following consequences:

heart failure and chronic renal failure;
uremia;
cerebral hemorrhage;
encephalopathy (neurotic).

In the latent form of the disease, deterioration of kidney function, shrinkage of the organ, and development of chronic renal failure are possible.

Preventive measures for glomerulonephritis in children include correct diagnosis and adequate treatment of diseases of the nasopharynx, streptococcal infections, and allergic manifestations.

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

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

The disease develops due to inflammation of the glomeruli

During this 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 the 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 types of infections;
previous respiratory diseases;
genetic predisposition.

Also, glomerulonephritis can be a consequence of complications after suffering 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:

constant headaches;
increased body temperature;
the occurrence of attacks of nausea, which usually end in vomiting;
decreased performance, weakness and fatigue;
a sharp deterioration in health;
the appearance of swelling on the eyelids and face;
pain in the lumbar region;
increased blood pressure;
change in the color of urine, which takes on a dark rusty hue;
decreased amount of urine.

The main danger of acute glomerulonephritis is that the disease can develop 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 basically the pathological process becomes chronic. In this case, swelling and changes occurring in urine can be observed for one year or more.

In order to accurately determine the presence of the disease based on the symptoms that appear, you should seek help from a pediatrician, urologist or nephrologist. Before prescribing a number of additional tests for a child, the doctor must first 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 diuresis and hematuria, increase in ESR, as well as an increase in harmful substances in the blood.

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

In addition to laboratory tests, a small patient should undergo an ultrasound examination, an immunogram, and a study of the renal vessels. This is necessary, first of all, in order to determine the increase in kidney volume and find out the full picture of the disease. In some situations, a biopsy is recommended, which allows us to clarify the variant of the pathological process. Based on all the above laboratory and instrumental examinations, the doctor will be able to make an accurate diagnosis. If the assumptions about the diagnosis are confirmed, the child is given consultations with specialized specialists, such as an otolaryngologist, geneticist, dentist and ophthalmologist.

The acute form of glomerulonephritis in childhood is treated exclusively in a hospital setting under the close supervision of the attending physician.

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

taking medications;
performing a set of exercise therapy exercises;
adherence to a strict pastel regime until 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;
diuretics;
blood pressure lowering agents;
hormonal drugs;
drugs aimed at reducing viscosity and normalizing blood clotting;
vitamin complexes;
means to enhance immunity.

During treatment it is very important to follow a diet

In the process of treating glomerulonephritis in children, it is also very important to observe. In this case, 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.

Pay attention! If acute glomerulonephritis becomes diffuse, the patient is required to undergo hemodialysis or surgery.

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

The child should be monitored by a nephrologist

Also, after treating the acute stage of childhood glomerulonephritis, if there are concomitant pathologies, it is strongly recommended to eliminate all foci of infection, as well as cure teeth, get rid of adenoids and all other diseases and abnormalities. But you shouldn’t do this right away; at least six months must pass after treatment. This applies to both acute and chronic forms of glomerulonephritis.

The basis for the prevention of childhood glomerulonephritis is timely diagnosis and professional treatment 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 prevention methods, they are considered very specific.

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

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

limit salt intake;
systematically undergo examinations by a pediatrician for preventive purposes;
promptly treat allergic diseases;
Avoid hypothermia and 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 possibility of getting 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, occurs quite rarely, and deaths 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;
severe convulsive seizures.

Childhood glomerulonephritis in itself is considered a rather severe and complex disease. Cases of complete relief from this pathological process are recorded quite rarely. One of the most common complications that this disease leads to is its transition to a chronic form.

Glomerulonephritis is a serious kidney disease that is becoming increasingly common in children. The pathology manifests itself with very unpleasant symptoms and is dangerous for its complications.

What is glomerulonephritis in children?

Glomerulonephritis is an inflammatory lesion of the renal glomeruli (glomeruli), leading to disruption of their function. The disease is infectious and allergic in nature. In pediatric nephrology, glomerulonephritis ranks second in frequency of occurrence, with boys being affected twice as often as girls. At risk are preschoolers and primary schoolchildren - from 3 to 10 years old; in children under 2 years old the disease is very rare.

The kidneys contain nephrons, each of which is formed from glomeruli - glomeruli of tiny vessels covered with a capsule - and a complex system of tubules communicating with the collecting ducts leading to the renal pelvis.

It is in the capillary glomeruli that the blood entering the kidneys is initially filtered and the so-called primary urine is separated. Its secondary filtration, with substances needed by the body still dissolved in it, occurs in the renal tubules, the loop of Henle. Having passed through the system of these tubules, primary urine becomes final, that is, all the substances necessary for the body (protein molecules, electrolytes, vitamins) are absorbed back, and the liquid with dissolved unnecessary elements flows through the collecting ducts into the pelvis system and is then excreted from the body. Inflammation of the glomeruli leads to the fact that they cannot perform their filtering function, that is, cleanse the blood of harmful substances.

The renal glomeruli filter the blood from harmful substances that are excreted in the urine.

Pathological changes occurring in the glomeruli during their inflammation:

the walls of the capillaries acquire increased permeability to blood cells, which causes blockage of the cavity of the glomerular capsule and renal tubules by the formed elements of blood;
microscopic blood clots form, blocking the vascular lumens;
the movement of blood through the capillaries of the glomeruli slows down or stops altogether;
the process of filtering blood in the kidney is completely disrupted;
over time, the walls of the vessels (and then the entire nephron) are replaced by connective, non-functional tissue, ultimately the kidney “building blocks” die;
due to the death of nephrons, a sharp decrease in the volume of purified blood occurs and renal failure syndrome develops; it is expressed in the fact that the necessary substances do not return to the bloodstream, they are excreted in the urine, and toxins, on the contrary, accumulate in the body.

Chronic kidney failure can lead to disability in a child.

Types of disease

Glomerulonephritis has a fairly broad classification. The pathology can be primary, that is, develop under the direct influence of a pathological factor (for example, streptococcal infection) on the kidney tissue, or secondary - occur against the background of an autoimmune pathology, for example, hemorrhagic vasculitis or systemic lupus erythematosus.

According to the clinical course, the pathology is:

acute;
chronic;
subacute (malignant).

Forms of acute inflammation of the glomeruli:

cyclic (with vivid manifestations) can occur in the following types, depending on the predominance of the symptom complex (syndrome):
- with nephrotic syndrome (manifested by edema, proteinuria - protein in the urine);
- with nephritic syndrome (with very pronounced edema, high levels of red blood cells, protein, casts in the urine, decreased protein fractions in the blood, hypertension, anemia);
- with hypertensive syndrome (with stable high blood pressure);
acyclic (latent) - an erased form that has a low-symptomatic or asymptomatic course, dangerous due to its imperceptible transition to chronic progressive inflammation.

The chronic process in children can occur in three ways:

hematuric (with red blood cells in the urine);
nephrotic (swelling and protein in the urine);
mixed

According to the prevalence of the inflammatory process, the following forms are distinguished:

minor glomerular changes;
diffuse;
focal (focal).

Glomerulonephritis is divided according to the localization of inflammation:

intracapillary (in the glomerular vessels themselves);
extracapillary (in the cavity of the glomerular capsule).

The nature of inflammation in pathology can be:

proliferative;
exudative;
mixed.

Video: classification of glomerulonephritis

Causes of different forms of glomerulonephritis

It is not always possible to identify the cause of the disease - in 85% of cases of acute inflammation and only in 10% of cases of chronic inflammation. The main factor in the development of pathology is infection. The onset of inflammation is provoked by:

As a rule, in children, the development of acute inflammation is provoked by an infectious disease caused by streptococcus suffered 2-4 weeks earlier - tonsillitis, scarlet fever, pharyngitis, streptoderma, pneumonia.

The chronic form of the disease in children is most often of a primary nature, in more rare cases it is a complication of an untreated acute process. The main role in the development of long-term inflammation of the glomeruli is played by the genetically determined response of the child’s immune system to the influence of an infectious antigen.

The causes of glomerulonephritis can be infectious and non-infectious factors

Inflammatory phenomena in kidney tissue can occur against the background of severe connective tissue pathologies:

rheumatism;
lupus erythematosus;
vasculitis;
endocarditis;
scleroderma.

Sometimes glomerular damage is associated with hereditary abnormalities that cause dysfunction of the immune system.

The disease can be triggered by poisoning with toxic substances, irradiation (radiation therapy), vaccination (introduction of a foreign protein), a severe allergic reaction in which a large number of immune complexes are released, causing inflammation of the kidney tissue and damage to the glomerular capillaries.

Factors predisposing to the development of pathology:

high sensitivity of the body to streptococcal pathogens;
carriage of certain strains of streptococcus;
burdened heredity;
foci of chronic inflammation on the skin or in the nasopharynx;
general hypothermia, cold (activation of streptococcus occurs).

Video: about the causes of glomerular inflammation

Manifestations of glomerulonephritis in children

Acute glomerulonephritis typically manifests itself with a rapid, violent onset:

high temperature;
a sharp deterioration in general health;
malaise;
headache;
nausea, bouts of vomiting;
soreness in the kidney area.

From the very first days, a sharp decrease in the amount of urine excreted by the child (oliguria) is noticeable, while it becomes cloudy (due to proteinuria) and acquires a specific shade - the color of “meat slop” (due to the admixture of blood). A characteristic sign of inflammation of the glomeruli is massive swelling, especially visible on the eyelids and face. The legs and sometimes other parts of the body may swell.

A child with acute glomerulonephritis has a characteristic appearance - a pale, puffy face, swelling on the eyelids

The child has a characteristic appearance - the skin is very pale due to vasospasm, the face is puffy. Blood pressure rises to 140–160 mm Hg. Art. On the part of the heart, tachycardia, muffled tones are observed, due to high pressure - expansion of the cardiac boundaries.

With timely treatment, renal functions are quickly restored - urine volume returns to normal after 3-7 days, initially polyuria is noted, that is, an increased amount of daily urine - excess fluid is removed from the body. Swelling gradually goes away, blood pressure decreases, and health returns to normal. Lastly, hematuria (blood in the urine) disappears.

Full recovery is possible in one to one and a half months, sometimes treatment is delayed up to 3 months. The final restoration of the altered glomeruli occurs only after a year or two.

In 1–2% of cases, acute inflammation becomes chronic, which can manifest itself in different ways:

The hematuric variant of the chronic process occurs most often in children. The disease progresses slowly and has a relapsing course. A characteristic feature of this form is prolonged hematuria (red blood cells in the urine, turning it rusty), which intensifies with exacerbation (macrohematuria). The child has virtually no edema, and his blood pressure remains within normal limits.
In chronic nephrotic glomerulonephritis, a typical wave-like course is observed with constant relapses (from 2 to 4 exacerbations per year). The leading symptoms in this form are urinary disturbances (decreased total quantity, swelling, presence of protein). The blood pressure may be slightly elevated or within normal limits.
The hypertensive variant of chronic inflammation in children is rare. The child complains of headaches, blurred vision, dizziness, general weakness, and hypertension is progressive. There are minor changes in urine, and there is usually no swelling.
In adolescents, a mixed form of pathology is more common. In this case, nephrotic signs are combined with hematuria and hypertension. The disease has a persistent progressive nature, manifested by persistent proteinuria (protein in the urine), early impairment of the functional ability of the kidneys. Examinations show severe destruction of renal tissue, fibroplastic changes in the glomeruli (proliferation of scar tissue in the cortex). This form is difficult to treat and threatens the development of chronic renal failure within 10 years from the onset of the disease. Clinical remission is achieved with great difficulty. Relapse is possible even in a transplanted kidney.

The period of decompensation (renal failure) manifests itself:

severe headaches, attacks of nausea and vomiting, which is associated with an increase in nitrogen compounds in the blood;
a significant increase in blood pressure due to impaired excretion of excess fluid, hormonal changes and changes in electrolyte balance;
polyuria (increased daily urine volume) as a result of insufficient concentrating ability of the kidneys, while the child experiences chronic thirst, headaches and muscle pain, general weakness, and dry skin.

Kidney failure is dangerous due to the development of uremia - the terminal stage of the syndrome. In this case, the kidneys finally lose their ability to maintain normal blood composition.

Latent glomerulonephritis is dangerous due to the paucity of its manifestations and the associated late diagnosis. Therefore, it is so important to make a timely and correct diagnosis in order to avoid serious consequences.

Diagnostic methods

Usually, parents turn to a pediatrician, who refers the child for examination to a pediatric nephrologist.

To make a diagnosis, it is important to ask parents about the child’s recent infections, existing chronic diseases, and the presence of congenital nephrological pathologies in close family members.

Characteristic symptoms, laboratory and instrumental tests allow the doctor to make the correct diagnosis and determine the form of the disease.

Laboratory

Laboratory diagnostics:

Clinical urine analysis shows:
- characteristic color - from light pink to dark rusty;
- the presence of a large number of red blood cells, hyaline, granular casts, protein;
- high urine density (with chronic inflammation and polyuria, the density is low);
Zimnitsky test - insufficient volume of urine excreted per day;
urine analysis according to Nechiporenko (detailed counting of formed elements in urine) - red blood cells, leukocytes, casts are much higher than normal;
Reberg's test in combination with the biochemistry of blood and urine demonstrates a violation of the glomerular filtration rate;
clinical blood test:
- slight increase in leukocytes (in the presence of an infectious focus);
- increased erythrocyte sedimentation rate;
- moderate anemia (with a chronic process - more pronounced);
blood biochemistry:
- decreased protein levels;
- presence of C-reactive protein;
- increased cholesterol, creatinine, urea;
- hyperazotemia (high level of nitrogen compounds);
- disorders of the coagulation system (increase in prothrombin index, decrease in antithrombin level, presence of fibrinogen breakdown products);
An immunological blood test shows an increase in the titer of antibodies to streptococcus, a high level of CEC (immune complexes).

One of the main laboratory signs of glomerulonephritis is a large number of red blood cells in the urine

Instrumental

Of the instrumental methods, ultrasound examination of the kidneys is used. In an acute process, ultrasound shows high echogenicity and a slight increase in the size of the organ; in a chronic process, the volume of the kidneys may be slightly reduced.

Ultrasound examination of the kidneys helps identify the inflammatory process

Kidney biopsy (histological examination of kidney tissue samples) is used for:

atypical manifestations of the disease;
early age of the patient (up to 3 years);
anuria (lack of urine);
persistent course with long-term persistence of hematuria and high protein in the urine;
signs of systemic pathology.

The patient must be referred for consultation to pediatric specialists:

Differential diagnosis

Differential diagnosis is carried out with the following diseases:

hereditary forms of nephritis;
hemorrhagic vasculitis;
pyelonephritis;
transient nephrotic syndrome due to acute respiratory viral infection or other infection;
systemic pathologies.

Having made a diagnosis, the doctor prescribes an individual treatment program for the small patient, aimed at eliminating the causes of the disease and its manifestations.

Treatment of pathology

Usually, a patient with glomerulonephritis is sent for inpatient treatment, especially if we are talking about an acute process. The child is prescribed bed rest for 7–10 days. After the pressure has normalized, the hematuria has decreased and the swelling has decreased, the restriction is removed.

Prolonged bed rest and an absolute decrease in physical activity are not recommended due to the risk of circulatory disorders and thromboembolism - blockage of small vessels with blood clots (especially in nephrotic syndrome).

The most important component of treatment is dietary nutrition - table No. 7. Sanitation of infectious foci is mandatory. Taking into account the causes of the disease and possible complications, drug therapy is prescribed.

Medicines

Antibiotic therapy is indicated from the first days in acute glomerulonephritis with a history of streptococcal infection. The drugs of choice are drugs from the penicillin group:

Amoxicillin;
Augmentin;
Ampicillin.

Cephalosporins or macrolides are less commonly prescribed.

For a viral infection, antiviral drugs are prescribed - Acyclovir or Novirin.

To combat edema in nephrotic syndrome, diuretics are used:

Furosemide (Lasix);
Hydrochlorothiazide;
Veroshpiron (Spironolactone);
Valsartan, Losartan - for older children.

In case of hidden edema and a significant decrease in protein fractions in the blood, the child is prescribed intravenous infusions of osmotic diuretics - Albumin, Reopoliglyukin, Poliglyukin. These drugs are contraindicated in case of very high blood pressure and a risk of developing heart failure in the child.

Normalization of blood pressure in the acute form of the disease is usually achieved by a salt-free diet and the administration of diuretics. In case of chronic glomerulonephritis of mixed and hypertensive form, the child is prescribed medications to lower blood pressure:

Enalapril;
Captopril.

The following medications are mandatory for inflammation of the renal glomeruli:

antiplatelet and antithrombotic drugs:
- Curantyl (Dipyridamole);
immunosuppressants to relieve inflammation:
- Long-term courses of prednisolone;
- Methylprednisolone;
cytostatics in combination with Prednisolone (with frequent relapses of the chronic process):
- Cyclosporine;
- Cyclophosphamide;
- Levamisole.

Very high levels of uric acid, creatinine and urea in the blood are an indication for hemodialysis - blood purification using an artificial kidney apparatus.

A patient who has suffered acute glomerulonephritis, after discharge from the hospital, must be registered with a pediatrician and pediatric nephrologist for five years with mandatory regular medical examinations. The child is exempt from physical education and preventive vaccinations. Spa treatment is recommended. With a chronic relapsing course of the disease, dispensary registration throughout life is indicated.

Photo gallery: medications for the treatment of glomerulonephritis

Heparin for glomerulonephritis is prescribed to prevent blood clots Chlorambucil is a drug prescribed to suppress immunological reactions that cause inflammation of the kidneys Nifedipine is prescribed for the hypertensive form of glomerulonephritis Furosemide is a diuretic drug that helps remove excess fluid from the body Prednisolone is included in all treatment regimens for glomerulonephritis Amoxiclav is an effective antibiotic against streptococcus
Eufillin is prescribed to dilate blood vessels and improve renal blood flow

Unconventional treatment

In no case can traditional medicine methods replace drug therapy for glomerulonephritis. Folk remedies can only complement traditional treatment, and their use must be agreed upon with a doctor.

Herbal collection is diuretic and anti-inflammatory:

Take 2 tablespoons each of anise seeds and rose hips, 1 tablespoon each of parsley roots and lovage, add 2 tablespoons of birch leaves.
Mix the raw materials and take a tablespoon of the mixture.
Pour 250 ml of cold water for 1 hour.
Boil for 15 minutes.
Leave until cool, strain.
Give the child one spoon 4 times a day.

Decongestant kidney tea:

Pour water (200 ml) over Orthosiphon stamen herb (a tablespoon) and boil in a water bath for 10 minutes.
Leave for half an hour.
Filter and bring to the original volume with boiled water.
Give your child 2 tablespoons of warm tea three times a day before meals.

Herbal collection:

In equal parts, mix black currant and nettle leaves, cornflower flowers, dry parsley root and damask herb. You can add plantain leaves and dried strawberries.
Pour a tablespoon of herbs into 250 ml of water, boil for 7 minutes and leave for at least an hour in a thermos.
Strain and give the child 30 ml 4 times daily before meals.

Diuretic tea:

Take a teaspoon each of corn silk and cherry cuttings.
Brew a glass of boiling water.
Give the child 20–40 ml to drink three times a day.

In a non-acute period, the child can be given milkshakes once a day:

with strawberry juice (dessert spoon per 100 ml of milk);
with carrot juice (2 tablespoons per glass of milk).

To strengthen vascular walls, prevent heart failure, and reduce nitrogen levels in the blood, you can make a delicious medicine from nuts and dried fruits:

Take a tablespoon of peeled walnuts, raisins, prunes, dried apricots, pour in honey, mix well.
Give your child 1 dessert spoon twice a day.

You can find many recipes from herbalists for the treatment of inflamed glomeruli, but they must be used with caution. For example, horsetail and bearberry, which are often used to treat kidney inflammation, cannot be used for glomerulonephritis, as they contribute to an increase in red blood cells in the urine, significantly thinning the blood. That is, hematuria increases, and there is a risk of hemorrhage.

Photo gallery: alternative treatments for glomerulonephritis

Corn silk helps improve diuresis Rose hips are useful for any inflammatory diseases Strawberry fruits help relieve inflammation, cleanse the blood and improve metabolism Nephrologists prescribe orthosiphon stamen as a decongestant Parsley root has diuretic, anti-inflammatory, hypotensive properties A mixture of dried fruits with honey and nuts is useful for strengthening immunity, vascular walls and improvement of blood composition

Physiotherapy

For acute and chronic inflammation, physiotherapeutic procedures are used that have the following goals:

stop the inflammatory process;
improve local blood circulation;
promote the removal of excess fluid;
normalize the functioning of the immune system.

A child with preserved kidney function may be prescribed:

magnetic therapy on the kidney area;
electrophoresis with novocaine, magnesium, calcium, antiseptic and antibacterial drugs;
irradiation of the lumbar region with infrared rays;
UHF therapy;
paraffin applications.

Physiotherapy is an important part of the treatment of glomerulonephritis in children

Surgical treatment

The disease itself does not require the use of surgical methods. Surgical treatment may be necessary in the presence of complications - severe renal failure and nephrosclerosis (wrinkling of the kidney). In such cases, an organ transplant may be required.

It is worth noting that glomerulonephritis can recur even in a transplanted kidney.

Diet food

In case of illness, the child’s nutrition should be based on diet No. 7, which contains little protein, excludes salt and maintains calorie content. In the absence of nephrotic syndrome, with minor hematuria and preserved kidney functionality, table No. 5 is prescribed - with a limitation of fried, fatty, spicy foods.

Therapeutic nutrition is prescribed for the entire period of active manifestations of the disease; after the onset of remission, the diet is gradually expanded. Limiting animal protein foods with diet No. 7 is especially important if the filtering function of the kidneys is impaired. The calorie content of the diet is increased due to carbohydrates and partly fats.

Food is prepared without salt. As swelling decreases and blood pressure normalizes, the amount of salt is gradually increased (ready-made dishes are added).

In case of oliguria, vegetable and fruit juices are excluded to prevent hyperkalemia, when edema resolves and diuresis normalizes, on the contrary, it is recommended to include foods rich in potassium in the diet - dried fruits, baked potatoes.

The amount of fluid consumed is calculated individually, taking into account the diuresis of the previous day (200 ml more urine excreted).

The menu should consist of the following dishes:

milk, vegetable and cereal soups with water, without broth;
a small amount of dietary boiled meat or lean fish;
pancakes, pancakes, bread without salt;
fresh, stewed, boiled, baked vegetables and fruits;
porridge, pasta;
milk, curdled milk, low-fat sour cream;
steamed eggs;
jelly, honey, jelly, jams, meringues;
Drinks include tea, juices, rosehip decoction.

For glomerulonephritis, the basis of nutrition should be cereals, soups, fruits and vegetables

Excluded from the diet:

broths;
canned food;
confectionery, baked goods;
onions, garlic, cauliflower, sorrel, radishes, mushrooms, legumes;
marinades, pickled vegetables;
apricots, grapes, cherries, currants;
ice cream, chocolate;
spices (except vanilla and cinnamon);
cocoa;
mineral waters;
sweet soda.

Video: Elena Malysheva about the treatment of glomerulonephritis

Prognosis and possible complications

Proper treatment of the disease in the vast majority of cases leads to recovery. Rarely does the pathology become chronic in children.

Acute inflammation can lead to the following complications:

nephrotic encephalopathy;
acute kidney or heart failure;
uremia (self-poisoning of the body with harmful substances that the kidneys could not remove);
cerebral hemorrhage.

The chronic process in children is accompanied by impaired renal function with the development of chronic renal failure (CKF) and nephrosclerosis (replacement of renal tissue with scar tissue).

Chronic renal failure is a severe complication of glomerulonephritis, requiring regular hemodialysis or kidney transplantation

Preventive measures

In order to prevent the development of pathology in a child, it is necessary to promptly and fully treat streptococcal and viral infections, ENT diseases, allergic conditions, and prevent hypothermia.

It is important to increase the overall resistance of the child’s body:

hardening procedures;
balanced diet rich in vitamins;
physical activity;
sufficient exposure to fresh air.

Despite its seriousness, glomerulonephritis, if detected early, responds well to treatment. A responsible approach, perseverance and patience of parents are an important component of victory over childhood kidney disease.