The younger the child, the heavier the kidneys.

The position is lower, reaching above the skeletal height when >2 years old.

The ureter is long and curved, and is easily compressed and twisted, causing obstruction. - Urinary retention may easily lead to infection.

The position of the infant's bladder is higher than that of older children. When the urine is full, it can be easily touched when pushed into the abdominal cavity.

Baby girls have a short urethra (1cm), and the external opening is exposed close to the anus, making them susceptible to infection.

Although the urethra of baby boys is longer, phimosis and foreskin are common, and they are also prone to infection.

●The glomerular filtration rate of newborns is low at birth, only 1/4 of that of adults, between 3 and 6 months of age It is 1/2 of an adult, 3/4 of an adult at 6 to 12 months, and reaches adult levels at 2 years of age. ●Serum creatinine (Cr): Different ages have different normal reference values.

●Newborns have low renal glucose threshold and are prone to glycosuria. ●Insufficient intake may cause hyponatremia; ●Excessive input of sodium ions: can cause sodium and water retention. ● Within 10 days after birth, potassium excretion capacity is limited - avoid potassium ion input

●Newborns and infants have poor urine concentration function - they are prone to dehydration when the amount is insufficient ●Although the dilution function is close to that of adults, due to the low GFR, the diuretic rate is slow - edema is easy to occur when the load is large or the infusion is too fast.

●Poor ability to excrete acid and retain alkali - prone to acidosis

slightly

93% of newborns urinate within 24 hours after birth, and 99% urinate within 48 hours after birth. Babies urinate more often, 15 to 16 times a day is normal. The dosage for preschool and school-age children is similar to that of adults (6 to 7 times a day).

(1) Urine color: Under normal circumstances, urine color is light yellow.

(2) Urine pH

(3) Urine specific gravity and osmotic pressure

(4) Urine routine

(5) Urinary protein

water and sodium retention

tonsillitis

Pyoderma

1. Hematuria

2. Reduced urine output

3. Edema

4. High blood pressure

5. Proteinuria - minor

It usually occurs within 1 to 2 weeks after the onset of illness. In addition to the above typical symptoms, one or more of the following symptoms occur:

1. Asymptomatic APSGN

⒉Extrarenal symptomatic acute nephritis

3. Acute nephritis manifested by nephrotic syndrome

Increased red blood cells in urine, indicating glomerular hematuria

Urinary protein is mostly large ~ and a variety of casts can be seen.

In the early stage of the disease, white blood cells and epithelial cells may be present, which is not caused by infection.

Mild anemia is common, mostly due to blood dilution.

White blood cells are slightly elevated or normal.

The erythrocyte sedimentation rate (ESR) is often slightly increased.

Serum C3 is significantly reduced early in the course of the disease and returns to normal within 6 to 8 weeks.

Those who do not recover within 8 weeks should consider other glomerular diseases.

It will increase frequently (it may not increase if it is caused by early use of penicillin or pyoderma)

Return to normal after 3 to 6 months.

History of previous infection

clinical manifestations

laboratory

1. Acute glomerulonephritis after infection with other pathogens

⒉Rapidly progressive nephritis

3. Acute urinary tract infection

4.lgA nephropathy

5. Membranoproliferative nephritis

6. Secondary nephritis

7. Acute attack of chronic nephritis

rest

diet

Anti-infective

Symptomatic treatment

Treatment of Hypertensive Encephalopathy/Severe Circulatory Congestion

massive proteinuria hypoalbuminemia

It is a clinical syndrome in which the permeability of the glomerular basement membrane is increased due to various reasons, resulting in a large amount of plasma protein being lost in the urine.

*massive proteinuria

*Hypoalbuminemia

Diagnostic requirements

Hyperlipidemia

Marked edema

"Three highs and one low"

primary

Secondary

congenital

Minimal change kidney disease - the most common, accounting for 80%

Non-minimal change kidney disease – 20%

① Simple NS: accounting for 80%~85%

② Nephritis type NS: accounting for 15%~20%

① Hormone-sensitive NS;

② Hormone-resistant NS;

③ Hormone-dependent NS;

④Recurrence and frequency of recurrence.

●It mostly occurs in people over 2 years old, with the peak incidence between 3 and 5 years old.

●Boys: Girls are (3~4): 1.

●The onset often occurs insidiously, without obvious triggers; it may also occur or recur after influenza, enteritis, etc.

●Children are generally in good condition at the beginning of the disease. As the disease progresses, they develop paleness, listlessness, loss of appetite, and often abdominal pain, abdominal discomfort, diarrhea, etc.

The most common and prominent symptoms. It begins with edema on the face and eyelids and gradually spreads to the limbs, with descending and sunken features. Severe cases include ascites, pleural effusion and scrotal effusion.

Simple nephropathy - without hematuria and hypertension.

Nephritis kidney disease - hematuria and varying degrees of hypertension may occur, and the course of the disease is often protracted and repeated.

proteinuria

hematuria

Albumin<30g/L

Total cholesterol>5.7mmol/L

decreased albumin

Increased ratio of alpha and beta globulin

Decreased gamma globulin ratio

reduce

increase

Simple kidney disease - blood complement C3 is generally normal

Partial nephritic kidney disease - blood complement C3 continues to decrease

Nephritis-type kidney disease may have ammonia (blood urea nitrogen >10.7mmol/L or 30mg/dl).

1. Should have 4 major characteristics

2.Clinical classification and diagnosis

Most common complications.

Respiratory tract, skin, and urinary tract infections are common, with the above respiratory tract infections being the most common

There may be "three lows" - hypokalemia, hyponatremia, and hypocalcemia;

Hyponatremia and hypovolemic shock—mostly caused by blind diuresis.

Renal vein thrombosis is the most common

Venous thrombosis of the femoral vein and other lower extremity veins may also occur

reason

(1) General treatment

(2) Symptomatic treatment (reduce swelling, prevent infection)

(3) Proteinuria-lowering treatment (hormones, ± immunosuppressants)

(4) Relapse prevention treatment

(5) Preventing the chronic development of renal pathology and treating chronic complications