Radical treatment of late-stage kidney disease in children

Nowadays, more and more people suffer from nephrotic syndrome. The disease does not discriminate between age and gender. Therefore, many children are also infected with the disease. However, since children themselves have poor resistance, children with kidney disease must receive timely and effective treatment. In this project, we will introduce the methods for the radical cure of children's kidney disease in the late stage.

Radical treatment of late stage kidney disease in children

1. General treatment

Those with severe edema and hypoproteinemia need to stay in bed and rest. They can get up and move around after the edema disappears and the general condition improves.

Give a normal amount of 0.8-1.0g/(kgd) of high-quality protein (mainly animal protein rich in essential amino acids) diet. The calories should be sufficient, and should not be less than 30-35kcal per kilogram of body weight per day. Although patients lose a large amount of urinary protein, a high-protein diet increases glomerular hyperfiltration, aggravates proteinuria and promotes the progression of kidney disease, so it is generally no longer recommended.

When edema occurs, a low-salt diet (<3g/d) should be adopted. To reduce hyperlipidemia, a diet rich in saturated fatty acids (animal fats) should be avoided, and a diet rich in polyunsaturated fatty acids (such as vegetable oils and fish oils) and soluble fiber (such as beans) should be consumed instead.

(II) Symptomatic treatment

1. Diuretic and detumescent

(1) Thiazide diuretics mainly act on the thick-walled segment of the ascending limb of the loop of Henle and the anterior segment of the distal convoluted tubule, inhibiting the reabsorption of sodium and chloride and increasing potassium excretion to promote diuresis. Long-term use should prevent hypokalemia and hyponatremia.

(2) Potassium-retaining diuretics mainly act on the posterior segment of the distal convoluted tubule, excreting sodium and chloride, but retaining potassium. They are suitable for patients with hypokalemia. When used alone, the diuretic effect is not significant, and they can be used in combination with thiazide diuretics. Commonly used are triamterene or the aldosterone antagonist spironolactone. Long-term use requires prevention of hyperkalemia, and patients with renal insufficiency should use it with caution.

2. Reduce urine protein

Persistent and heavy proteinuria can lead to glomerular hyperfiltration, aggravate tubular-interstitial damage, and promote glomerular sclerosis, which is an important factor affecting the prognosis of glomerular disease. It has been proven that reducing urine protein can effectively delay the deterioration of renal function.

In addition to effectively controlling hypertension, angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) can also reduce urinary protein independently of lowering systemic blood pressure by reducing intraglomerular pressure and directly affecting the permeability of the glomerular basement membrane to macromolecules. When using ACEI or ARB to reduce urinary protein, the dose used should generally be larger than the conventional antihypertensive dose to achieve a good therapeutic effect.

The above is the radical cure method for late-stage kidney disease in children that we introduced. We hope that parents will pay attention to it. When a child is sick, not only the child will feel uncomfortable, but the parents will also feel distressed. Therefore, parents should take their children to a regular hospital for examination and treatment in time for a speedy recovery.