Patient's question:
NoDoctor's answer:
Hello: Nephritis in children generally refers to glomerulonephritis, which is a diffuse, non-suppurative disease affecting both kidneys. It most commonly occurs in school-aged children, with the ages of 6-9 being the most prevalent. It is often secondary to bacterial or viral infections of the upper respiratory tract. However, the onset of nephritis is not due to direct bacterial or viral damage to the kidneys causing inflammation, but rather due to a series of autoimmune reactions triggered in the body after the pathogen enters, leading to kidney damage and subsequent illness.Most cases of this condition can be cured with timely treatment. Common complications include heart failure, hypertension, encephalopathy, and acute renal failure.
Key Self-Diagnosis Points
The earliest symptom of this condition is swelling of the eyelids, which may then extend to the lower limbs and the entire body. The swelling is usually pitting. Reduced urine output and hematuria are the other two major characteristics of nephritis. Some children may also have elevated blood pressure upon medical examination.
The clinical presentation of the disease can range from mild to severe, and mild cases are often overlooked by parents. Severe cases may develop the following complications:
1. Heart failure, characterized by rapid breathing, restlessness, a fast heart rate, and enlargement of the liver and spleen;
2. Hypertension, characterized by headache, blurred vision, confusion, convulsions, and significantly elevated blood pressure;
3. Acute renal insufficiency, characterized by oliguria or anuria, azotemia, and acidosis.
Treatment Recommendations
It is important to seek medical attention promptly. All medications should be purchased under a doctor's prescription and used under medical guidance. Under the doctor's permission and if home conditions permit, treatment can also be administered at home.
During the acute phase, children can take traditional Chinese medicine (TCM) herbal formulas or patent medicines under the guidance of TCM diagnosis:
1. For wind-water type, it is advisable to ventilate the lungs and promote diuresis. Medications such as Wutai San, Tripterygium Glycosides Tablets, and Zishen Wan can be used.
2. For damp-heat type, it is advisable to clear heat, resolve toxicity, and promote diuresis. Medications such as Kunming Mountain Tablets, Jinquancao Granules, and Niaoshi Siwei Tablets can be used.
3. For cold-damp type, it is advisable to promote diuresis and reduce swelling. Medications such as Wujisi Wan,, and Jiefan Wan can be used.
Children in the recovery phase may have spleen deficiency, and medications such as Shenqi Gao and Buzhongyiqi Wan can be used to strengthen the spleen and replenish qi.
Precautions
During the first 2-3 weeks of the illness, the child should rest in bed. Protein intake (such as eggs, meat, and fish) should be controlled, and a low-salt diet should be followed. foods and fruits should be consumed, and daily urine output should be monitored to limit excessive fluid intake. Most children will show improvement after 2-4 weeks of treatment and rest.
During rest, it is important to avoid infections, especially upper respiratory tract infections. The living environment should be warm, humid, quiet, and clean, creating a comfortable resting space for the child. Skin care should be maintained to prevent bedsores caused by prolonged bed rest.
During the acute phase of nephritis, severe complications such as heart failure, hypertensive encephalopathy, and acute renal failure may occur. If these complications are not treated promptly and reasonably, they can not only affect the course of the disease but also lead to serious consequences. Therefore, if the child's urine output continues to decrease (less than 400 mL per day for school-aged children, or less than 300 mL per day for pre-school children) or if there is anuria (less than 50 mL per day), acute renal failure should be considered. If symptoms such as rapid breathing, coughing, shortness of breath, difficulty breathing, frothy bloody sputum, or inability to lie flat appear, it may indicate circulatory congestion and heart failure. In the early stages of the disease, symptoms such as headache, dizziness, blurred vision, nausea, vomiting, convulsions, or confusion may indicate hypertensive encephalopathy. If any of these symptoms occur, the child should be hospitalized immediately.
The acute symptoms of nephritis usually subside within 1-4 weeks. Residual microscopic hematuria and a small amount of proteinuria often take about 6 months to disappear. Further medical research has confirmed that complete recovery of kidney lesions may take about 1 year. Therefore, it is recommended:
- At least 2 weeks of bed rest;
- School-aged children should rest for 8-12 weeks, returning to school only after the erythrocyte sedimentation rate returns to normal;
- Avoid strenuous exercise for 6-12 months;
- Actively prevent and treat infections.