Boy gains 5 kg in 4 days due to kidney failure

Vinh LongA 12-year-old boy suddenly gained 5 kg in 4 days, accompanied by little urination, and enlarged genitals.

On June 30, doctors from the Department of Pediatrics, Vinh Long Xuyen A General Hospital said that the patient was taken to the doctor by his mother in a state of general edema; swollen face, hands, feet and genitals.

The test results showed that albumin (a type of protein) in the child’s blood decreased low but protein in the urine increased, the erythrocyte sedimentation rate increased, blood lipids (fat) increased, peritoneal effusion, and pleural effusion were low. .

Through consultations between doctors specializing in Pediatrics, Endocrinology, Urology, the doctors diagnosed the child with nephrotic syndrome. The baby was treated with Prednisone, with two mg/kg/day for 4 weeks, up to a maximum of 60mg per day, along with a high-protein, low-salt diet.

Now, after 15 days of treatment, the baby has markedly reduced edema, increased urination, returned to original weight, urine tests showed negative proteinuria three times in a row, blood protein gradually increased. The patient was discharged from the hospital, however, it is necessary to continue taking medicine and maintain a scientific diet and care regimen. At the same time, the baby must periodically re-examine, so that the doctor can assess the disease status and reduce the appropriate dose according to the regimen.

According to doctors, nephrotic syndrome is a chronic disease with a long duration of treatment and follow-up, the possibility of recurrence, the effectiveness of treatment depends a lot on the cooperation of the patient and family.

Nephrotic syndrome is a group of glomerular diseases that increase the permeability of the glomerular membrane, causing protein in the blood to be lost through the urinary tract. Characteristic manifestations of the disease are generalized edema, commonly in the eyes, abdomen, legs and testicles, oligouria, proteinuria, hypoproteinemia and hyperlipidemia. Nephrotic syndrome can lead to complications such as kidney failure, infection, malnutrition, embolism, low calcium… Most children with nephrotic syndrome have no known cause, accounting for 90% of children with nephrotic syndrome. children 1-10 years old.

Nephrotic syndrome was first treated with high-dose prednisone. Depending on the patient’s response to treatment, the specialist doctor will adjust the dose accordingly according to the regimen. If there is no response to treatment after 4 weeks of aggressive therapy, the child is considered for a kidney biopsy and in addition to immunosuppressive drugs.

Doctors recommend that this is a disease that can recur after remission, so it is very important to re-examine and monitor the baby at home according to the instructions of the doctor. Parents should give children a lot of protein, limit salt and adhere to the treatment regimen, do not arbitrarily stop the drug without a doctor’s prescription. In addition, in the case of children with nephrotic syndrome being treated with high-dose corticosteroids or immunosuppressive drugs, vaccination with live attenuated vaccines should be avoided. for children.

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