Hydronephrosis in children

　　Hydronephrosis in children is mainly caused by ureteral obstruction and urine reflux, and the specific causes are described as follows.

　　1. Ureteral obstruction:This is a common disease causing hydronephrosis, and the reason is that a small segment of the ureter narrows and causes obstruction, making it difficult for urine in the kidneys to flow into the bladder and stagnate in the kidneys. Usually, by resecting the narrowed segment of the ureter and reconnecting it, the ureter can be kept unobstructed, and the condition of hydronephrosis can be improved.

　　2. Urine reflux:Under normal circumstances, urine flows from the kidneys through the ureters to the bladder, and then排出体外. Urine reflux is an abnormal phenomenon where urine is backflowed from the bladder into the ureters, even into the kidneys. At this time, the kidneys will have both urine ready to flow into the bladder and urine flowing back from the bladder, which will cause too much water in the kidneys, leading to hydronephrosis.

　　Nephrotic hydronephrosis in children can be accompanied by urinary tract infection, occasionally with renal rupture, and children with severe hydronephrosis may have hypertension and uremia. The urine reflux in children is a congenital disease, and most patients do not have symptoms or feel pain. However, when symptoms appear, the kidneys may have already been infected; and the age of infection can range from a few months to teens. However, the damage to the kidneys is not necessarily due to infection. Even without the phenomenon of infection, the kidneys may gradually be damaged. Children's kidneys are not very mature kidneys, and each infection will damage a part of the renal function, and these damaged renal functions will not recover; for example, if this infection damages 10%, the next time it may damage 20%, and by the time they grow up, they may only have 50% of normal function left. Damaged kidneys can lead to hypertension, anemia, chronic kidney disease, or even renal failure.

　　Most pediatric hydronephrosis patients come to seek medical attention with gastrointestinal discomfort and abdominal masses (accounting for more than half), and larger patients more often present with intermittent low back pain, hematuria, urinary tract infection, etc. Renal rupture is occasionally seen, and children with severe hydronephrosis may have hypertension and uremia.

　　The occurrence of pediatric hydronephrosis is often related to congenital developmental malformations, therefore, pregnant women should do well in prenatal diagnosis and examination, avoid contact with toxic and harmful substances during pregnancy to prevent the occurrence of congenital malformations. When related symptoms and signs of the disease are found, active treatment should be carried out to avoid serious illness. Early detection, early diagnosis, and early treatment are very important for the prevention of this disease.

　　The examination of pediatric hydronephrosis includes laboratory tests, ultrasound, X-ray examination, and radionuclide examination, etc. The specific examination methods are described as follows.

　　1. Laboratory examination:With the improvement of various invasive examination techniques, the range of sampling has expanded. The comprehensive application of advanced sensitive immunological and molecular biological techniques shows a good application prospect in the diagnosis and treatment of hydronephrosis. The collection of renal pelvis urine through ureteral catheter and the detection of urine protein indicators confirm that creatinine (Cr) and albumin/creatinine are ideal indicators for evaluating the degree of damage to the renal tubules and glomeruli of the diseased kidney. An increase in urine THP/Cr and IgG/Cr indicates severe damage to the glomeruli and renal tubules of the diseased kidney, thus suggesting that it is helpful in choosing the treatment method and predicting the efficacy for children with hydronephrosis.

　　2. Ultrasound examination:It has a high clinical value in the diagnosis of hydronephrosis. The contrast is not dependent on renal function, and it is even more valuable for those with poor renal function or no function.

　　3. X-ray examination:The X-ray diagnosis of pediatric nephrotic hydronephrosis includes a variety of examination methods such as intravenous urography, antegrade pyelography, retrograde pyelography, and Whitaker perfusion pressure testing. Due to the invasive nature of the operation methods and the restrictions of contraindications, antegrade, retrograde, and Whitaker perfusion pressure testing are no longer routinely used for children suspected of having pelviureteral obstruction. Currently, intravenous urography is more commonly used, which can clearly show the size, shape, density, and obstruction site of the pelvis and calyces, and roughly estimate the glomerular filtration function. It is of great help in diagnosing hydronephrosis and in evaluating renal function after hydronephrosis. Clinically, it is often used to further clarify the presence and extent of hydronephrosis and urinary system stones found by ultrasound.

　　4. Radioisotope examination:The advantages are high sensitivity, low radiation absorption, no allergic reactions, and can measure glomerular filtration rate (GFR). Clinical application criteria include: evaluating kidney function; judging whether there is obstruction; evaluating treatment efficacy.

　　The diet of pediatric renal hydrops patients should be light, and the intake of sodium should be restricted, and it is not advisable to eat too much high-protein food. The specific dietary precautions are as follows.

　　1. Try to eat less or not eat salty and high-protein foods. For example, foods with a lot of salt, eggs, potatoes, soybeans, etc., can be appropriately consumed white radish and honey, which are beneficial for dredging the waterways.

　　2. Do not eat fried and pickled foods, and foods such as cola, hamburgers, milk, sugar, nuts, beans, and meat dishes should also be eaten in moderation.

　　3. Increase energy intake, but to avoid increasing the burden on the kidney with hydrops, it is not advisable to eat too much protein-rich food.

　　4. Avoid eating beans and their products (such as tofu, sprouts, bean powder, etc.).

　　5. Diet should be light, avoid drinking alcohol and spicy foods, eat less greasy and animal protein-rich foods (such as fatty meat, shrimp, crabs, etc.).

　　Pediatric renal hydrops belongs to the category of 'lumbago' in traditional Chinese medicine, and children of all ages can be affected, with children being more common.

　　1. Herbs of pediatric renal hydrops experience formula:White mugwort root, also known as mugwort root, sweet root. It is long cylindrical, 30-60 cm in length, 2-4 mm in diameter. The surface is yellowish white or light yellow, with luster, the joints are obvious, the length between joints is not equal, and it tastes sweet.

　　2. Quantity of pediatric renal hydrops experience formula:Use 10 each time, about 20 centimeters in length.

　　3. Experience formula for pediatric renal hydrops:Wash and crush it, put it in a sand pot (do not use a pot that has been used to cook medicine), boil it open, and add two white chrysanthemums (those that are about to open, that is, those that are about to bloom, there are no fresh ones, dried ones can also be used, they can be found in tea shops), and drink it after it cools naturally. If you are feeding water to a child, the amount is about enough for the child to drink in one day. Once a day, in the morning, for three consecutive days. In the future, cook and drink it irregularly for the child. Effects can be seen in seven or eight days.

　　This food therapy must be used under the guidance of a traditional Chinese medicine doctor, and should not be treated blindly on one's own, in order to achieve satisfactory efficacy.