Pediatric kidney disease

　　The occurrence of pediatric kidney diseases is related to renal dysplasia, heredity, immune system dysfunction, and infection, and the specific causes of onset are as follows.

　　1. Malformation:The urinary system includes renal dysplasia. Unilateral renal dysplasia, such as unilateral renal dysplasia of renal units, obstructive diseases, and so on, all of which are problems of development.

　　2. Heredity:Genetic diseases are more common in childhood, so special attention should be paid to genetic kidney diseases.

　　3. Immune dysfunction:Such as acute glomerulonephritis, etc.

　　4. Infection:Such as urinary tract infection, children should be paid attention to.

　　Children with kidney disease may develop acute renal failure, tubular function damage, and infection. The specific complications are described as follows.

　　1. Acute renal failure.

　　2. Tubular function damage: Clinically, renal glycosuria, aminoaciduria, and Fanconi syndrome in severe cases are often seen. These children have a poor response to glucocorticoid treatment and a poor long-term prognosis.

　　3. Infection is a common complication of pediatric kidney disease and also the main cause of death. Common infection sites include the respiratory tract, skin, urinary tract, and abdomen.

　　The clinical manifestations of children with kidney disease include general edema, increased blood pressure, and oliguria, and the specific manifestations are described as follows.

　　1. General edema: Initially seen in the eyelids and face of children with kidney disease, gradually spreading to the whole body. Severe patients may have pleural effusion, peritoneal effusion, scrotal, penile, and labial edema, which is mostly凹陷性.

　　2. Blood pressure is normal or increased.

　　3. There may be oliguria or hematuria.

　　The occurrence of pediatric kidney disease is related to maldevelopment of the kidney, heredity, immune dysfunction, and urinary tract infection. To prevent the occurrence of the disease, prenatal diagnosis and consultation should be done to prevent the birth of children with the disease. Prevent infection, and treat it promptly if infection occurs. Participate in aerobic exercise, exercise appropriately, do more physical activities in the sun, and sweat more, which can help to eliminate excess acidic substances in the body and prevent the occurrence of the disease.

　　The examination of children with kidney disease includes urine routine, blood tests, abdominal X-ray, and ultrasound examination, etc. The specific examination methods are as follows.

　　1. To make an accurate diagnosis, urine routine, plasma protein, and blood cholesterol should be checked first.

　　2. To distinguish between simple nephrotic syndrome and nephritis nephrotic syndrome, urine routine, erythrocyte sedimentation rate, blood urea nitrogen, serum creatinine, serum C3, urine C3, liver function, and hepatitis B virus markers should be checked.

　　3. To prevent and treat infection, midstream urine culture, chest and abdominal X-ray, blood culture, and other tests are required.

　　4. If necessary, renal ultrasound, renal scan, and intravenous pyelography should be performed to understand the renal function.

　　Children with kidney disease should eat foods with low protein content, limit the intake of sodium and potassium, consume adequate amounts of carbohydrates and appropriate amounts of fat, and pay attention to calcium supplementation. The specific dietary precautions are described as follows.

　　1. Low-protein diet: The amount of protein supply is determined according to the condition to reduce the burden on the kidneys. The duration of low-protein diet should not be too long to prevent anemia.

　　To eliminate edema, it is necessary to limit sodium and water intake. Low-salt, salt-free, or low-sodium diets should be provided according to the condition, urine output, and edema situation.

　　3. Avoid eating high-potassium foods such as mushrooms, shiitake mushrooms, jujube, shellfish, beans, vegetables, and fruits.

　　4. Sufficient carbohydrates and appropriate fats: Most of the dietary energy is provided by carbohydrates. Supplementing enough carbohydrates can prevent insufficient energy.

　　5. Provide an appropriate amount of energy: Severe children need to rest in bed, reduce energy consumption, and a decrease in activity can reduce appetite, so the daily supply of energy does not need to be too high.

　　6. Pay attention to calcium supplementation in children with kidney disease.

　　The clinical differentiation of childhood nephrotic syndrome in children with kidney disease is divided into three types: deficiency of lung and spleen, deficiency of spleen, and deficiency of spleen and kidney. The pathogenesis is mainly the dysfunction of the lung, spleen, and kidney, especially the weakness of the spleen and stomach, leading to disorders of water and fluid metabolism, deficiency of Qi and blood in the viscera, and the vital energy cannot resist the pathogenic factors. The spleen and stomach are the root of the posterior life, mainly in charge of the transformation and transportation of grains and soup, and the source of Qi and blood generation. Children have not yet developed their transformation and transportation function, and are often injured by diet, resulting in some symptoms of the spleen and stomach.

　　In the basic formula, Taizi参, Huo et al., Baimi, Chenpi, Jineijin, which is actually the modification of 'Wu Wei Yi Gong San'.

　　Children with nephrotic syndrome mostly have a simple type, which is sensitive to hormones and has a high recurrence rate. The reason is related to insufficient lung qi, loss of defense of the body surface, and easy to be attacked by external pathogenic factors of six evils. Therefore, in the basic formula, add Huangqi and Fangfeng to invigorate the body and strengthen the body surface, which is actually the modification of the formula of 'Yu Ping Feng San'. The clinical manifestations of older children (10-14 years old) are mostly deficiency of spleen and kidney, and the treatment should be to invigorate the spleen and nourish the kidney. Therefore, the basic formula is added with Shengdi, Shanyao, Niujingzi, and Haoliancao, which is actually the modification of 'Liu Wei Di Huang Soup' and 'Er Zhi Wan'.

　　In the treatment of children with kidney disease, there is often a manifestation of deficiency with excess. At this time, it is necessary to select clearing agents according to syndrome differentiation, but it is not advisable to use dispersing and attacking evil methods for a long time, otherwise the vital energy will be seriously injured, and the treatment will be delayed. When taking hormones, children may have symptoms such as flushed cheeks, increased appetite, and being overweight and active, which should not be regarded as real heat. Give bitter and cold drugs to clear heat, but on the basis of the above treatment, it should be supplemented with nourishing Yin and cooling blood products.

　　The combination of traditional Chinese and Western medicine in the treatment of childhood nephrotic syndrome can complement each other's strengths and weaknesses, reduce the side effects of hormones, enhance the immunity of the child's body, which is the key to reducing recurrence and relapse. The treatment of nephrotic kidney disease with hormone therapy also adopts a continuous long-term course, which is also beneficial to the recovery of the child's physical vitality.