Allergic Dis., Nerves Sys. Dis., Digestive Sys. Dis., Respiratory Sys. Dis., Urinary Sys. Dis., Surgery Dis.

Urinary System Disease

Nephritic Syndrome:

Nephritic Syndrome is recognized clinically by excretion of protein from urine, reduction of blood albumen, increase of blood lipids.

Sometimes if is accompanied by excretion of blood from urine, hyper blood pressure and fast reduction of glomerulus filtration. When it occurs with glomerular diseases of initial nephrotic tic syndrome and if it occurs as a part of general disease or as a result of clear reason, it is called secondary nephritic syndrome. In borne nephritic syndrome is a patrimonial kind of nephritic syndrome that occurs in preschool period. Excretion of protein from urine and swelling are initial signs and often occur immediately after birth. Treatment of this decease doesn’t have a good result. It may cause to death of child before 2 years-old.

Incidence:

It begins in the ages of 2-7 years-old in males and its incidence will be 2-3 years-old.

Signs:

Proteinuria (albuminoidal), reduction of blood protein (hypoalbuminemia), increase of blood cholesterol, swelling, also blood pressure changes (natural reduction or increase), reduction of C.S.F and urine output decrease, sometimes hematuria, and other signs such as face puff (particularly eyes), swelling of genital edges or testicles, gaining weight, dim and foaming urine, reparative disorder, diarrhea and infection.

Progressive swelling occurs when density of sodium albumin becomes fewer than 2.5gr⁰/dl. That happens for two reasons:

A. Starling Rule: (excretion of protein, decrease of blood oncotic pressure, movements of vascular fluid to inter-tissue space and swelling).

B. Increasing serration of aldosterone (reduction of vascular volume, aldosterone, reabsorption of salt and water from both kidneys). The volume of serum is fewer than natural amount (because of retentions in inter-tissue space).

 

Doing tests including analysis of urine, completely counting blood, assessment of sodium electrolytes, calcium, phosphorus and nitrogen of blood Uren, creatinine, total protein, albumin, globulin, cholesterol, triglyceride and….

Protein is recognized by excretion of urine protein that most times its level reaches more than 2 gr per m² during 24 hours.

The results of dipstick are often +-4. Specific weight of urine may be high and according to protein consistency.

Serum cholesterol may be more than 220 mg/dl. Serum sodium is usually fewer, that is about 130-135ml equivalent per liter. Hemoglobin and hematocrit are usually usual.

Treatment:

The purpose of medical treatment is to reduce protein.

For reducing swelling: limiting salt and water, full protein diet, consumption of diuretic maintaining k (in acute swelling).

For reducing excretion of protein:

Prednisolone at the beginning of treatment daily 2 g/kg (maximum 80mg) for long power fail or, reduction of relapse amount: alkyl kanz (Cyclophosphamide, Chlorambucil) , with consumption of selective drug (Prednisone). Proteinuria is stopped at first week (negative dipstick is well constantly for 2 days), If treatment with prednisone doesn’t reparative system diseases.

Nursing:

Controlling the record and reporting daily vital signs, daily weight, state of swelling, absorption and excretion, liquids, measuring circum of abdomen and as cites, reparative noises, level of activity and signs of infection.

Skin cares include changing position for prevention of skin brittleness, cleaning surfaces that locate near each other because of swelling (males vaginal, vaginal edges, abdomen), warm compressing swollen eyelids, preventing of exposure to cold or warm, wearing wide cloths and short nails, preventing of inflammation (especially pulmonary and dermal ones) few nutrition and in more times, resting in the cases of tiredness and acute swelling.

Instruction of necessary points in consumption of steroids (prednisone).

Controlling and reporting complications (bleeding and digestive sore) , preventing of inflammation , consuming them with food or milk in the case of vomiting, encouraging a child to explain her/his own ideas about change of mental imagination.

Nutrition of children affected to nephritic syndrome should be less and at many times, and include full protein and calorie food. Its water and salt should be limited in the case of limited swelling:

The main complication in a child affected to nephritic syndrome is inflammation. A child affected to nephritic syndrome can do her/his own daily tasks. She/he must prevent of contact with infectious factors and persons.