Children's kidney disease follow-up examination items

What are the later examination items for children with kidney disease? This is the first issue that patients with acute nephritis need to consider, because streptococcal infection is a common factor in the formation of acute nephritis. So in addition to discussing the symptoms of acute nephritis, everyone is discussing the examination of acute nephritis. So what are the examination items for acute nephritis?

1. Routine blood test: Both red blood cell count and white blood cell count may be abnormal, and erythrocyte sedimentation rate may increase, but they usually return to normal within 2 to 3 months.

2. Blood biochemistry and renal function examination. The glomerular filtration rate (GFR) decreases to varying degrees, but the renal plasma flow can still be normal, so the filtration fraction is often reduced. Compared with the involvement of glomerular function, the renal tubular function is relatively good, and the renal concentrating function can usually be maintained. Transient azotemia is common in clinical practice, with increased blood urea nitrogen and creatinine. Children who are not restricted in water intake may have mild dilutional hyponatremia. In addition, sick children may also have hyperkalemia and metabolic acidosis. Plasma protein may decrease slightly due to blood dilution. In patients with proteinuria reaching the level of nephrotic syndrome, blood albumin decreases significantly and may be accompanied by a certain degree of hyperlipidemia.

3. Urine test. Urine routine test can reflect many situations, as follows:

Since hematuria is an important finding of acute nephritis, the occurrence of microscopic hematuria often needs to be determined by routine urine examination.

4. Blood complement determination. Except for individual cases, the total complement and C3 in the blood decreased significantly in the early stage of nephritis and returned to normal after 6 to 8 weeks. This regular change is a typical manifestation of this disease. The degree of decrease in blood complement has no obvious correlation with the mild symptoms of acute nephritis.

5. Cytological and serological examinations: The positive rate of hemolytic streptococci cultured from the pharyngeal or skin infection foci after the onset of acute nephritis is about 30%, and it is even more difficult to detect in those who receive penicillin treatment in the early stage. After streptococcal infection, corresponding antibodies can be produced, and the detection of antibodies is often used to confirm the prodromal streptococcal infection.

6. B-ultrasound of both kidneys. B-ultrasound shows that the patient's kidneys are enlarged.

7. Renal puncture. Renal puncture is also called renal biopsy. Usually, typical cases do not require renal puncture, but if it is difficult to differentiate from rapidly progressive nephritis; or if there is still hypertension, persistent hypocomplementemia or renal function impairment 3 months after the onset of the disease.