Acute kidney failure in a child (ARF) is a serious problem that parents have to face. Depending on the severity of the condition, it can provoke a violation of all body functions, which leads to a severe disorder of homeostasis.
That is why it is so important to identify this disturbing pathology at an early stage. To do this, you need to learn a little more about this clinical condition and clarify what are the symptoms of acute renal failure in a child. Let's take a closer look at them.
Why the disease develops
If we talk about the factors that lead to such a pathology, then there can be many of them. Some causes of acute renal failure in children cannot be avoided through preventive measures. Therefore, it remains timely detection of the first symptoms of this disease.
For example, if we are talking about newborn children, then such factors include various anomalies in the development of the cardiac apparatus,lack of kidneys, congenital vascular pathology. AKI can cause a blood clot to enter the renal vein or obstruction of the urinary tract. An infection could have entered the baby's blood. This leads to quite severe sepsis.
Also, babies are prone to severe dehydration. It can occur due to an infectious disease from which the baby began to suffer while still in the womb. Sometimes this happens due to injuries and other damage during labor itself.
If we talk about the causes of acute renal failure in a child aged from one to 3 years, then in this case, other factors that can provoke such a condition come first. Of course, one should not exclude anomalies and congenital ailments. However, in addition to them, children at this age often suffer from kidney infections, complex pathologies occurring in the intestines and severe metabolic disorders.
If we are talking about older children, aged 3 to 14 years, then in this situation, doctors most often diagnose acute renal failure in a child against the background of poisoning with strong chemicals or drugs. Severe infections, injuries, and situations that cause an acute reaction of the body can also lead to acute renal failure. For example, a burn or severe bleeding can provoke such an ailment.
Regardless of age, acute renal failure in a child manifests itself in a certain sequence. Therefore, it will be useful to know how the unpleasantpathology.
Stages of disease development
There are several stages in the manifestation of pathology. Consider the main stages.
- Initial. In this case, the possible symptoms will depend on the specific cause of the disease. By itself, renal failure does not manifest itself in any way. In some situations, parents note a decrease in the volume of urine in a child. However, this does not always happen. The first stage lasts relatively short, from 6 to 24 hours.
- Oligoanuric. This stage is characterized by more obvious signs of acute renal failure in children. This is due to the fact that the internal organs gradually begin to be affected. It should be alert that the child began to suffer from wheezing in the lungs, low pressure (although this had never happened before), problems with bowel function, and a very sharp decrease in the volume of fluid during urination. This stage lasts from days to several weeks. During this time, the doctor should identify the exact cause of the alarming symptoms and prescribe the best treatment for acute kidney failure in children.
- Restorative. If the parents and the doctor took measures in a timely manner, then adequate treatment will help the baby get rid of the disease. He will begin the recovery phase. During this period, the urinary system begins to work again as it should, all body functions return to normal. As a rule, this stage takes from 5 days to two weeks.
- Recovery. The child ceases to experience any unpleasant symptoms. However, you need to understand that a full recovery is possible not earlier thanin a year. Since the kidney function was impaired, it will take quite a long time for the body to be able to return everything to its previous state.
Speaking of acute renal failure in a child, it is worth noting that in this case, recovery is easier than in an adult. This is due to the fact that a young organism is able to regenerate affected cells at a faster rate. Therefore, most often this disease does not pose a danger. But only if the treatment started on time.
Otherwise, the pathology will go into a chronic stage, and it will be very difficult to get rid of it.
Acute kidney failure in a child: symptoms of the disease
Standard signs of pathology, as a rule, most noticeably begin to appear closer to the beginning of the second stage. Therefore, it is worth learning more about them. For example, you should consult a doctor if the child began to gain weight too quickly. In this case, weight gain occurs mainly due to swelling. At the same time, there will be a decrease in urine during trips to the toilet.
Also, the symptoms of acute renal failure in children include blanching of the skin. In this case, the child will constantly itch and complain of severe itching. Additionally, it is worth checking the breath of the child. If it is fetid, then this is also a rather serious sign of the development of the described pathology.
As with many other ailments, the baby will sleep and eat poorly. It is worth noting the appearance of his weakness. Loss of interest in active games. The child gets tired too quickly.
Also evidence of developing acute and chronic renal failure in children may be the appearance of dry mouth, nausea, vomiting and diarrhea. Also, be sure to check the pressure readings of the fumes. If it is lowered, and the pulse is too slow, then this is also one of the signs of acute renal failure.
If the child is already talking, he may begin to complain of shortness of breath, pain in the chest or abdomen. Such a clinical picture indicates that it is necessary to immediately diagnose acute renal failure in a child. Only then can treatment begin.
Diagnostic measures
This is a necessary step. Regardless of the cause of acute renal failure in a child, the diagnosis will help to understand what exactly the doctor has to deal with. As a rule, such events are complex. This means that first of all, an inspection is necessarily performed, and then the necessary laboratory tests are carried out. First of all, the doctor tries to identify the causes of the disease during the conversation. At the same time, he should be guided by the protocol for acute renal failure in children under the number R-R-023. It describes the stages of the disease and its manifestations. Based on this, an initial examination and survey is being carried out.
After that, the little patient is sent for laboratory tests. To do this, you need to take a sample of blood, urine and feces of the child. This will help determine which infections the patient may be suffering from. Further, adhering to the acute protocolkidney failure in children, specialists perform a number of other procedures.
Visual diagnosis
At this stage, it is important to see the full picture of the condition of the child's kidneys. To do this, first of all, ultrasound, CT or MRI is performed, an x-ray is taken. The doctor checks for kidney stones.
If there is a theory that acute insufficiency developed against the background of blockage by a thrombus, then more detailed analyzes will be required. Numerous tests are carried out for this.
First of all, it is necessary to examine the anatomy of the kidneys of a particular patient. To do this, a tube with a small light bulb must be inserted into his urethra. It is necessary in order to install a catheter through which a special coloring liquid will go. It is necessary in order to make a high-definition x-ray.
An MRI will also be required, as this research method is considered more reliable. The doctor must understand whether structural changes have occurred. If they affect the urinary tract, then in this case a stronger magnetic radiation will be concentrated around the abdomen.
Only after all these activities will it be possible to proceed with immediate therapeutic measures.
Additional events
It is very important to evaluate the work of the kidneys. Therefore, blood biochemistry is mandatory. Additionally, you need to clarify the indicators of urea, protein, sodium and other components. For this, the urine of a small patient is studied.
If serious changes were detected, then in this case, the tests are givenagain in a few days. But the level of urea will need to be determined daily. Based on the data obtained, a graph can be drawn up that will help clarify the features of the condition of a small patient.
Also, daily ultrasound and a number of additional mandatory studies will be required. However, such measures are most often required when it comes to a newborn baby. The first days of life can be critical, so professionals need to get near-real-time data.
Features of treatment
When it comes to acute renal failure in children, clinical recommendations must be strictly followed. Especially with the development of pathology in very tiny babies. As a rule, in such situations, babies are placed in special chambers - incubators. They maintain a constant and optimal temperature regime. At the same time, every few hours, the specialist must turn the baby over so that he is not in the same position. At such a young age, this is fraught with the development of rhabdomyosis. It is also recommended to have massage sessions several times a day.
It is important to constantly monitor the state of the heart and respiratory rate. Blood pressure is being checked. Doctors also monitor any changes in the patient's body temperature. Urine is collected every hour. It is also necessary to weigh at least once every 12 hours. This will help to understand if he is gaining mass.
Treatment at the second stage of pathology development
If the initial stage of the development of pathology has already passed, then thisIn this case, a number of measures are required to help alleviate the condition of the baby. First of all, it is necessary to correct the so-called volemic disorders. For this, a weak glucose solution or saline solution is used. The infusion is administered over 30-60 minutes. Also, the doctor may prescribe albumin, infucol and other drugs.
If no effect is observed, then in this case the course of glucose administration is repeated. It can be replaced with 0.9 percent saline. In this case, the dosage of the composition is calculated depending on additional factors. For example, premature babies receive less fluid than full-term newborns.
Also in the process of treatment, it is necessary to improve renal blood flow. To accomplish this, dopamine or a 4% dopamine solution is usually given.
If a decrease in myocardial contractions has been diagnosed, then in this case, cardiotonic drugs will be required.
Acute renal failure in children: clinical guidelines for prevention
If we talk about events of this type, then first of all, parents should do everything possible to completely eliminate risk factors. For example, acute renal failure can occur against the background of numerous serious diseases that were not diagnosed in time in a child. In order to avoid unpleasant consequences, it is recommended to undergo a full examination annually and be sure to show the baby to a therapist.
When it comes to children who are alreadyfaced with an illness, then you need to monitor the water balance of a small patient, especially if he is on inpatient treatment.
If we talk about the recommendations that are intended for the doctors themselves, then in this case, experienced specialists advise to be very careful when prescribing any drug. In some situations, you can get by with a diet that implies a reduced protein content. If there is a real risk that liver failure will occur, then so-called shock therapy is used as a prophylaxis. However, in this case, we are not talking about extreme abuse of people, but about the fact that a special solution is introduced into the bloodstream, which helps the body recover. Also, the components of the liquid help prevent the development of further pathology.
If we talk about acute renal failure in a child, disease prevention implies, first of all, caring for a baby who has had this disease. First of all, actions should be aimed at restoring the volume of fluid and blood. For this, as a rule, transfusions are used. It is also equally important to completely restore the lack of interstitial tissue fluid. Additionally, kidney drainage is performed. To do this, they are filled with a special solution.
As well as therapy, so-called asthmatic drugs can be used. These include Reopoliglyukin, Gelatinol and others. They are introduced in a volume of up to one and a half liters. However, exceed theseindicators are by no means possible. Otherwise, osmotic nephrosis can be caused. If we talk about medical preventive measures, then osmotic diuretics play a big role in them.
There are also recommendations for parents. First of all, in no case should you experiment with certain medicines. Acute renal failure is a very serious pathology, so the treatment of the disease is carried out exclusively by specialists. If we are talking about the child who has a predisposition to such a disease, then it is extremely difficult to avoid it. However, regardless of this, it will be useful to maintain the baby's immune system at the proper level. It is better to spend as much free time as possible in the open air and carefully check the child's diet. It should not contain chemical additives or other components that are not recommended for use.
Chronic renal failure in a child
In this case, we are talking about a non-specific syndrome that can occur against the background of impaired renal function. It is easy to guess that the pathology passes into the chronic stage if it progresses, and no treatment is provided. There are many classifications of chronic insufficiency. Only a specialist can determine it more accurately.
If we talk about the reasons for the development of this form of pathology, then in this case you need to pay attention to several factors. For example, there is a possibility that before this the child had a slight decrease in renal function.function. Also, this can occur against the background of progressive nephropathies. There is an increase in the instability of the cell membrane. In rare situations, acute and chronic renal failure in children can occur while taking potent drugs. In addition, there is a certain group of children who are more susceptible to such an ailment.
For example, parents of those children who suffer from severe uropathy should be especially careful about the he alth of babies. Also at risk include children with hereditary nephritis. It can be expressed in a variety of forms. These can be congenital or acquired diseases.
If we talk about the manifestations of chronic renal failure, then first of all there are changes in the parenchyma of the kidneys. Later, the number of nephrons that are able to function is significantly reduced. Gradually, the affected cells begin to be replaced by connective tissue. At the first stages of the disease, normal cells begin to perform the function of the affected nephrons. However, this compensatory function is not able to act for a long time. With urine, metabolic products cease to be excreted to a normal extent. Instead, they linger in the body. And this, in turn, leads to serious damage to tissues and organs. If the water balance is disturbed, then this only aggravates the situation.
If we talk about the initial stage of chronic renal failure, then in this case, in children, on the contrary, the volume of urination first increases,and then sharply decreases. If even in this case no treatment follows, then a stage may occur at which urine will not form at all. It is not difficult to guess that this can lead to the worst consequences. Therefore, do not delay to the last, it is better to immediately treat. The child's body, especially in the first years of life, is only being formed and is not able to fully withstand all possible failures. Therefore, prevention, examination and, if necessary, diagnostic measures should be carried out regularly.
