EN ИН KIDNEY DISEASES IN CHILDREN BYJCNH 2021.pdf

Loading…
KIDNEY DISEASES IN
CHILDREN
Adrenal
glands
Left
KIDNEY
right
KIDNEY

Loading…
KIDNEY DISEASES IN
CHILDREN
•The kidneys are the main organ of the urinary
system, which filters and cleanses the blood
from toxins, maintains its normal composition
and secretes hormones that regulate blood
pressure and the number of red blood cells in
the blood.
•In a newborn child, the kidneys are in an
immature state and begin to fully perform their
functions only by the age of two.
•During the period of growth and development
of the child, the load on the kidneys increases

•The kidneys ensure the constancy of the
chemical composition of the body. They
release excess metabolic products and excess
fluid, regulate a person's need for water and
chemicals, control blood pressure, stimulate
the formation of red blood cells, vitamin D.
•It should be noted that in children, as a
result, the anatomical and physiological
features of the organs of the urinary system
largely determine the nature of pathology
and the specifics of the clinical course of
diseases.
•In children, the kidneys are relatively larger
in volume and weight than in adults

•Kidney growth occurs mainly in the first
year of a child's life. In the process of
growth, the topography of the kidneys also
changes. Renal pelvises in newborns and
infants are relatively large, and their walls
are poorly developed.
•The ureter in children is relatively wider
and longer than in adults, has a convoluted
course, kinks.
•The bladder has a number of structural
features and undergoes a number of
significant changes during development, the
mucous membrane of the bladder is
relatively thick, but it is loose, well supplied
KIDNEY DISEASES IN
CHILDREN
Adrenal
glands
Left
KIDNEY
right
KIDNEY

•Kidney diseases in children can be divided into
3 main groups:
• hereditary diseases
•congenital malformations
•acquired diseases

Loading…

Function of the glomerulus
•The number of glomeruli is
1.5x106.
•120-180 liters of liquid are filtered
per day
•GFR = f (Vblood flow Sfiltration
Pfiltration)
•Intraglomerular blood flow
parameters are regulated by the
tone of afferent and efferent
arteries (blood flow and pressure),
mesangial cells (filtration rate)
•The tone of arterioles and
mesangial cells is regulated by
vasoactive substances synthesized
in the endothelium: nitric oxide,
prostacyclin, endothelin.

•Kidney diseases:
•congenital
•acquired

What are the causes of kidney disease in
children?
Kidney disease in children can be caused
by
birth defects
hereditary diseases
infection
nephrotic syndrome
systemic diseases
trauma
urine blockage or reflux

Common Kidney Diseases in Children
Nephrotic Syndrome
Cystic
Hereditary
Congenital
Glomerulonephritis
Vasculitis
Acquired kidney diseases:
•diffuse glomerulonephritis
• pyelonephritis

Loading…
KIDNEY DISEASES IN
CHILDREN
Adrenal
glands
Left
KIDNEY
right
KIDNEY

Loading…
KIDNEY DISEASES IN
CHILDREN
•The kidneys are the main organ of the urinary
system, which filters and cleanses the blood
from toxins, maintains its normal composition
and secretes hormones that regulate blood
pressure and the number of red blood cells in
the blood.
•In a newborn child, the kidneys are in an
immature state and begin to fully perform their
functions only by the age of two.
•During the period of growth and development
of the child, the load on the kidneys increases

•The kidneys ensure the constancy of the
chemical composition of the body. They
release excess metabolic products and excess
fluid, regulate a person's need for water and
chemicals, control blood pressure, stimulate
the formation of red blood cells, vitamin D.
•It should be noted that in children, as a
result, the anatomical and physiological
features of the organs of the urinary system
largely determine the nature of pathology
and the specifics of the clinical course of
diseases.
•In children, the kidneys are relatively larger
in volume and weight than in adults

•Kidney growth occurs mainly in the first
year of a child's life. In the process of
growth, the topography of the kidneys also
changes. Renal pelvises in newborns and
infants are relatively large, and their walls
are poorly developed.
•The ureter in children is relatively wider
and longer than in adults, has a convoluted
course, kinks.
•The bladder has a number of structural
features and undergoes a number of
significant changes during development, the
mucous membrane of the bladder is
relatively thick, but it is loose, well supplied
KIDNEY DISEASES IN
CHILDREN
Adrenal
glands
Left
KIDNEY
right
KIDNEY

•Kidney diseases in children can be divided into
3 main groups:
• hereditary diseases
•congenital malformations
•acquired diseases

Loading…

Function of the glomerulus
•The number of glomeruli is
1.5x106.
•120-180 liters of liquid are filtered
per day
•GFR = f (Vblood flow Sfiltration
Pfiltration)
•Intraglomerular blood flow
parameters are regulated by the
tone of afferent and efferent
arteries (blood flow and pressure),
mesangial cells (filtration rate)
•The tone of arterioles and
mesangial cells is regulated by
vasoactive substances synthesized
in the endothelium: nitric oxide,
prostacyclin, endothelin.

•Kidney diseases:
•congenital
•acquired

What are the causes of kidney disease in
children?
Kidney disease in children can be caused
by
birth defects
hereditary diseases
infection
nephrotic syndrome
systemic diseases
trauma
urine blockage or reflux

Common Kidney Diseases in Children
Nephrotic Syndrome
Cystic
Hereditary
Congenital
Glomerulonephritis
Vasculitis
Acquired kidney diseases:
•diffuse glomerulonephritis
• pyelonephritis• pyelonephritis
•interstitial nephritis
•renal stone disease nephrotic
syndrome in collagenoses

Loading…
systema urinarium

. The urinary system (urinary
system) of a person is a
system of organs that form,
accumulate and secrete urine
in a person. It consists of a
pair of kidneys, two ureters, a
bladder and a urethra. An
analog in invertebrates is
nephridium
Symptoms of kidney disease in
children•lower back pain (acute or, conversely,
pulling)
•cloudy urine with particles of blood
(hematuria) can indicate chronic
pyelonephritis or urolithiasis
• increased temperature in combination with
other symptoms of kidney disease
•high blood pressure signs of facial swelling
in the lower back, and sexual organs
constant fatigue,
• lack of energy dry mouth, the constant
need to drink a sharp increase or decrease

•Acute glomerulonephritis
(post-streptococcal) occurs most often in
school-age children, naturally after a certain
period after a streptococcal infection of the
nasopharynx or respiratory tract.
•Much less often, nephritis occurs after an
infection of a different localization. The
interval after infection with beta-hemolytic
streptococcus group A may be 7-14 days.

•Symptoms are manifested by general
malaise, headache and weakness with the
gradual addition of pallor and slight
swelling of the skin with the predominant
localization of edema on the eyelids, the
back of the hands and feet.
•The color of urine may change, up to the
color of "meat slops", its amount
decreases somewhat. In urine tests,
erythrocytes are detected in large
numbers, the amount of protein,
leukocyte and erythrocyte cylinders
increases. Relatively rarely and as a sign
of a severe form of the disease, blood
pressure may rise and attacks of

•Acute glomerulonephritis
• (Acute glomerulonephritis
•— is a group of kidney diseases that
differ in their structure, treatment
approaches and causes, but all of them
primarily lead to damage to the renal
glomeruli.
• Glomeruli, or glomeruli, are bundles of
blood vessels with small pores through
which blood is filtered in the kidneys.

•Causes of acute glomerulonephritis
•Acute glomerulonephritis often occurs after
an infection caused by beta-hemolytic
streptococcus group A (BGSA).
•The following strains can lead to kidney
diseases: Such glomerulonephritis is called
acute post-streptococcal glomerulonephritis
(OPSHN) [
•The risk of developing OPSHN depends on
the localization of infection: after
pharyngitis, it occurs in 5-10% of cases,
after a skin infection, for example
streptoderma— in 25% of cases.
•Recently, OPGSN in developed countries is

Nephrologists note with concern an increase in the frequency of
kidney diseases in children. This is due to many factors:
environmental degradation, reduced immunity, and a decrease
in the quality of life

• pyelonephritis
•interstitial nephritis
•renal stone disease nephrotic
syndrome in collagenoses

Loading…
systema urinarium

. The urinary system (urinary
system) of a person is a
system of organs that form,
accumulate and secrete urine
in a person. It consists of a
pair of kidneys, two ureters, a
bladder and a urethra. An
analog in invertebrates is
nephridium
Symptoms of kidney disease in
children•lower back pain (acute or, conversely,
pulling)
•cloudy urine with particles of blood
(hematuria) can indicate chronic
pyelonephritis or urolithiasis
• increased temperature in combination with
other symptoms of kidney disease
•high blood pressure signs of facial swelling
in the lower back, and sexual organs
constant fatigue,
• lack of energy dry mouth, the constant
need to drink a sharp increase or decrease

•Acute glomerulonephritis
(post-streptococcal) occurs most often in
school-age children, naturally after a certain
period after a streptococcal infection of the
nasopharynx or respiratory tract.
•Much less often, nephritis occurs after an
infection of a different localization. The
interval after infection with beta-hemolytic
streptococcus group A may be 7-14 days.

•Symptoms are manifested by general
malaise, headache and weakness with the
gradual addition of pallor and slight
swelling of the skin with the predominant
localization of edema on the eyelids, the
back of the hands and feet.
•The color of urine may change, up to the
color of "meat slops", its amount
decreases somewhat. In urine tests,
erythrocytes are detected in large
numbers, the amount of protein,
leukocyte and erythrocyte cylinders
increases. Relatively rarely and as a sign
of a severe form of the disease, blood
pressure may rise and attacks of

•Acute glomerulonephritis
• (Acute glomerulonephritis
•— is a group of kidney diseases that
differ in their structure, treatment
approaches and causes, but all of them
primarily lead to damage to the renal
glomeruli.
• Glomeruli, or glomeruli, are bundles of
blood vessels with small pores through
which blood is filtered in the kidneys.

•Causes of acute glomerulonephritis
•Acute glomerulonephritis often occurs after
an infection caused by beta-hemolytic
streptococcus group A (BGSA).
•The following strains can lead to kidney
diseases: Such glomerulonephritis is called
acute post-streptococcal glomerulonephritis
(OPSHN) [
•The risk of developing OPSHN depends on
the localization of infection: after
pharyngitis, it occurs in 5-10% of cases,
after a skin infection, for example
streptoderma— in 25% of cases.
•Recently, OPGSN in developed countries is

Nephrologists note with concern an increase in the frequency of
kidney diseases in children. This is due to many factors:
environmental degradation, reduced immunity, and a decrease
in the quality of life

• pyelonephritis
•interstitial nephritis
•renal stone disease nephrotic
syndrome in collagenoses

Loading…
systema urinarium

. The urinary system (urinary
system) of a person is a
system of organs that form,
accumulate and secrete urine
in a person. It consists of a
pair of kidneys, two ureters, a
bladder and a urethra. An
analog in invertebrates is
nephridium
Symptoms of kidney disease in
children•lower back pain (acute or, conversely,
pulling)
•cloudy urine with particles of blood
(hematuria) can indicate chronic
pyelonephritis or urolithiasis
• increased temperature in combination with
other symptoms of kidney disease
•high blood pressure signs of facial swelling
in the lower back, and sexual organs
constant fatigue,
• lack of energy dry mouth, the constant
need to drink a sharp increase or decrease

•Acute glomerulonephritis
(post-streptococcal) occurs most often in
school-age children, naturally after a certain
period after a streptococcal infection of the
nasopharynx or respiratory tract.
•Much less often, nephritis occurs after an
infection of a different localization. The
interval after infection with beta-hemolytic
streptococcus group A may be 7-14 days.

•Symptoms are manifested by general
malaise, headache and weakness with the
gradual addition of pallor and slight
swelling of the skin with the predominant
localization of edema on the eyelids, the
back of the hands and feet.
•The color of urine may change, up to the
color of "meat slops", its amount
decreases somewhat. In urine tests,
erythrocytes are detected in large
numbers, the amount of protein,
leukocyte and erythrocyte cylinders
increases. Relatively rarely and as a sign
of a severe form of the disease, blood
pressure may rise and attacks of

•Acute glomerulonephritis
• (Acute glomerulonephritis
•— is a group of kidney diseases that
differ in their structure, treatment
approaches and causes, but all of them
primarily lead to damage to the renal
glomeruli.
• Glomeruli, or glomeruli, are bundles of
blood vessels with small pores through
which blood is filtered in the kidneys.

•Causes of acute glomerulonephritis
•Acute glomerulonephritis often occurs after
an infection caused by beta-hemolytic
streptococcus group A (BGSA).
•The following strains can lead to kidney
diseases: Such glomerulonephritis is called
acute post-streptococcal glomerulonephritis
(OPSHN) [
•The risk of developing OPSHN depends on
the localization of infection: after
pharyngitis, it occurs in 5-10% of cases,
after a skin infection, for example
streptoderma— in 25% of cases.
•Recently, OPGSN in developed countries is

Nephrologists note with concern an increase in the frequency of
kidney diseases in children. This is due to many factors:
environmental degradation, reduced immunity, and a decrease
in the quality of life

Этиология
•A. Primary, idiopathic: nephrotic syndrome
with hematuria

•B. Secondary, post-infectious:
•acute post-streptococcal GN acute nephritic
syndrome after a previous streptococcal
infection (tonsillitis, skin, scarlet fever,
catheter, etc.).
Prevalence
•Acute glomerulonephritis occurs in patients of
all ages, but there are two peaks of morbidity:
at 5-12 years and after 60 years [3] [4].
•Men suffer from glomerulonephritis more
often.
•About 470,000 cases of acute
glomerulonephritis are detected annually, the
incidence rate ranges from 9 to 29 cases per
100,000 population

•The glomerular filter consists of 3 layers: the endothelium,
permeated with pores. Freely passing the plasma with the
components dissolved in it, it delays the shaped elements of the
blood. Basal membrane Filtration slit between the legs of
podocytes. After passing the filter, the filtrate enters the Bowman
space – the initial section of the renal filtration system. The
preserved filter prevents the absolute majority of proteins from
entering the Bowman space. Any damage to the glomeruli will
lead to a decrease in GFR and the appearance of protein and
blood cells in the urine.

Этиология
•A. Primary, idiopathic: nephrotic syndrome
with hematuria

•B. Secondary, post-infectious:
•acute post-streptococcal GN acute nephritic
syndrome after a previous streptococcal
infection (tonsillitis, skin, scarlet fever,
catheter, etc.).
Prevalence
•Acute glomerulonephritis occurs in patients of
all ages, but there are two peaks of morbidity:
at 5-12 years and after 60 years [3] [4].
•Men suffer from glomerulonephritis more
often.
•About 470,000 cases of acute
glomerulonephritis are detected annually, the
incidence rate ranges from 9 to 29 cases per
100,000 population

•The glomerular filter consists of 3 layers: the endothelium,
permeated with pores. Freely passing the plasma with the
components dissolved in it, it delays the shaped elements of the
blood. Basal membrane Filtration slit between the legs of
podocytes. After passing the filter, the filtrate enters the Bowman
space – the initial section of the renal filtration system. The
preserved filter prevents the absolute majority of proteins from
entering the Bowman space. Any damage to the glomeruli will
lead to a decrease in GFR and the appearance of protein and
blood cells in the urine.

Этиология
•A. Primary, idiopathic: nephrotic syndrome
with hematuria

•B. Secondary, post-infectious:
•acute post-streptococcal GN acute nephritic
syndrome after a previous streptococcal
infection (tonsillitis, skin, scarlet fever,
catheter, etc.).
Prevalence
•Acute glomerulonephritis occurs in patients of
all ages, but there are two peaks of morbidity:
at 5-12 years and after 60 years [3] [4].
•Men suffer from glomerulonephritis more
often.
•About 470,000 cases of acute
glomerulonephritis are detected annually, the
incidence rate ranges from 9 to 29 cases per
100,000 population

•The glomerular filter consists of 3 layers: the endothelium,
permeated with pores. Freely passing the plasma with the
components dissolved in it, it delays the shaped elements of the
blood. Basal membrane Filtration slit between the legs of
podocytes. After passing the filter, the filtrate enters the Bowman
space – the initial section of the renal filtration system. The
preserved filter prevents the absolute majority of proteins from
entering the Bowman space. Any damage to the glomeruli will
lead to a decrease in GFR and the appearance of protein and
blood cells in the urine.

•From the first days of life,
hereditary and genetically
determined diseases often
manifest themselves. Among the
infectious factors, intrauterine
infection dominates, penetrating
the body of the crumbs during
childbirth.

•1. Classification of kidney diseases in children

• I. Hereditary and congenital nephropathies: 1) anatomical abnormalities of
the structure of the kidneys and urinary organs: a) kidney malformations:
quantitative (agenesis, aplasia, additional kidneys), positional (dystopia,
nephroptosis, rotation), formal (horseshoe s– and l-shaped kidneys);
•b) malformations of the ureters;
•c) abnormalities of the structure of the bladder and urethra;
•d) abnormalities of the structure and location of the renal vessels, including the
lymphatic system; e) abnormalities of the innervation of the urinary system
with neurogenic bladder syndrome;
•2) disorders of differentiation of the renal structure: a) with cysts; b) without
cysts; 3) hereditary nephritis (without hearing loss, with hearing loss);
• 4) tubulopathy;
• 5) dysmetabolic nephropathies with crystalluria (oxalaturia, uraturia);
•6) nephro-and uropathies in chromosomal diseases;
•7) amyloidosis; 8) embryonic tumors.
Loading…

•II. Acquired diseases of the kidneys and urinary
organs:
•1) glomerulonephritis;
•2) interstitial nephritis;
•3) pyelonephritis;
• 4) infection of the urinary tract;
• 5) kidney tumors;
•6) injuries to the kidneys and urinary organs;
•7) urolithiasis;
• 8) secondary kidney diseases in acute infections,
diabetes, burn disease.
Гломерулонефрит
•GN for the duration of the disease:
• 0-3 weeks-acute
•3 weeks-months-subacute
• A year or more – chronic GN
•for glomerular lesions
• Focal – less than 50%
•Diffuse – more than 50%
•GN by glomerular lesion volume
•Segmental (captures part of the glomerulus)
• Total (captures the entire glomerulus)
Often develops on the background of
hemorrhagic vasculitis - D. Schonlein
Genoche Purpura

Edem
a

Syndromes of glomerulonephritis:
1. Urinary syndrome: proteinuria recurrent hematuria,
which can range from microhematuria (asymptomatic)
to macrohematuria leukocyturia Cylindrical shape
2. Hypertension: - sodium and water retention (secondary
hyperaldosteronism, decreased glomerular filtration
rate in severe CRF) - hypersensitivity to normally
functioning pressor mechanisms
3. Edematous syndrome
4. Nephritic syndrome -oliguria - hematuria - hypertension
- edema

Clinical manifestations GN
Nephrotic syndrome:
-severe proteinuria
-- edema
-- hypo-albuminemia
-- hyperlipidemia
-hyper-coagulants.
-status - hematuria
-- AG
-- oliguria
Hematuric form:
pronounced.
hematuria
-Proteinuria
- - hypertension
-- oligo-anuria
-- Hypo-of complementaria - hypo-
albuminemia
- - edema
- - pain in the stomach..
- encephalopathy

Nephritic syndrom
•NS is a manifestation of acute glomerular
inflammation, usually of a reversible nature.
Development time-from 1 day to 1-2 weeks Is
characterized by:
•Oliguria (urine output less than 400 ml/day)
Reduced GFR due to glomerular obturation by
white blood cells, cell proliferation, and
mesangial cell contraction

•From the first days of life,
hereditary and genetically
determined diseases often
manifest themselves. Among the
infectious factors, intrauterine
infection dominates, penetrating
the body of the crumbs during
childbirth.

•1. Classification of kidney diseases in children

• I. Hereditary and congenital nephropathies: 1) anatomical abnormalities of
the structure of the kidneys and urinary organs: a) kidney malformations:
quantitative (agenesis, aplasia, additional kidneys), positional (dystopia,
nephroptosis, rotation), formal (horseshoe s– and l-shaped kidneys);
•b) malformations of the ureters;
•c) abnormalities of the structure of the bladder and urethra;
•d) abnormalities of the structure and location of the renal vessels, including the
lymphatic system; e) abnormalities of the innervation of the urinary system
with neurogenic bladder syndrome;
•2) disorders of differentiation of the renal structure: a) with cysts; b) without
cysts; 3) hereditary nephritis (without hearing loss, with hearing loss);
• 4) tubulopathy;
• 5) dysmetabolic nephropathies with crystalluria (oxalaturia, uraturia);
•6) nephro-and uropathies in chromosomal diseases;
•7) amyloidosis; 8) embryonic tumors.
Loading…

•II. Acquired diseases of the kidneys and urinary
organs:
•1) glomerulonephritis;
•2) interstitial nephritis;
•3) pyelonephritis;
• 4) infection of the urinary tract;
• 5) kidney tumors;
•6) injuries to the kidneys and urinary organs;
•7) urolithiasis;
• 8) secondary kidney diseases in acute infections,
diabetes, burn disease.
Гломерулонефрит
•GN for the duration of the disease:
• 0-3 weeks-acute
•3 weeks-months-subacute
• A year or more – chronic GN
•for glomerular lesions
• Focal – less than 50%
•Diffuse – more than 50%
•GN by glomerular lesion volume
•Segmental (captures part of the glomerulus)
• Total (captures the entire glomerulus)
Often develops on the background of
hemorrhagic vasculitis - D. Schonlein
Genoche Purpura

Edem
a

Syndromes of glomerulonephritis:
1. Urinary syndrome: proteinuria recurrent hematuria,
which can range from microhematuria (asymptomatic)
to macrohematuria leukocyturia Cylindrical shape
2. Hypertension: - sodium and water retention (secondary
hyperaldosteronism, decreased glomerular filtration
rate in severe CRF) - hypersensitivity to normally
functioning pressor mechanisms
3. Edematous syndrome
4. Nephritic syndrome -oliguria - hematuria - hypertension
- edema

Clinical manifestations GN
Nephrotic syndrome:
-severe proteinuria
-- edema
-- hypo-albuminemia
-- hyperlipidemia
-hyper-coagulants.
-status - hematuria
-- AG
-- oliguria
Hematuric form:
pronounced.
hematuria
-Proteinuria
- - hypertension
-- oligo-anuria
-- Hypo-of complementaria - hypo-
albuminemia
- - edema
- - pain in the stomach..
- encephalopathy

Nephritic syndrom
•NS is a manifestation of acute glomerular
inflammation, usually of a reversible nature.
Development time-from 1 day to 1-2 weeks Is
characterized by:
•Oliguria (urine output less than 400 ml/day)
Reduced GFR due to glomerular obturation by
white blood cells, cell proliferation, and
mesangial cell contraction

•From the first days of life,
hereditary and genetically
determined diseases often
manifest themselves. Among the
infectious factors, intrauterine
infection dominates, penetrating
the body of the crumbs during
childbirth.

•1. Classification of kidney diseases in children

• I. Hereditary and congenital nephropathies: 1) anatomical abnormalities of
the structure of the kidneys and urinary organs: a) kidney malformations:
quantitative (agenesis, aplasia, additional kidneys), positional (dystopia,
nephroptosis, rotation), formal (horseshoe s– and l-shaped kidneys);
•b) malformations of the ureters;
•c) abnormalities of the structure of the bladder and urethra;
•d) abnormalities of the structure and location of the renal vessels, including the
lymphatic system; e) abnormalities of the innervation of the urinary system
with neurogenic bladder syndrome;
•2) disorders of differentiation of the renal structure: a) with cysts; b) without
cysts; 3) hereditary nephritis (without hearing loss, with hearing loss);
• 4) tubulopathy;
• 5) dysmetabolic nephropathies with crystalluria (oxalaturia, uraturia);
•6) nephro-and uropathies in chromosomal diseases;
•7) amyloidosis; 8) embryonic tumors.
Loading…

•II. Acquired diseases of the kidneys and urinary
organs:
•1) glomerulonephritis;
•2) interstitial nephritis;
•3) pyelonephritis;
• 4) infection of the urinary tract;
• 5) kidney tumors;
•6) injuries to the kidneys and urinary organs;
•7) urolithiasis;
• 8) secondary kidney diseases in acute infections,
diabetes, burn disease.
Гломерулонефрит
•GN for the duration of the disease:
• 0-3 weeks-acute
•3 weeks-months-subacute
• A year or more – chronic GN
•for glomerular lesions
• Focal – less than 50%
•Diffuse – more than 50%
•GN by glomerular lesion volume
•Segmental (captures part of the glomerulus)
• Total (captures the entire glomerulus)
Often develops on the background of
hemorrhagic vasculitis - D. Schonlein
Genoche Purpura

Edem
a

Syndromes of glomerulonephritis:
1. Urinary syndrome: proteinuria recurrent hematuria,
which can range from microhematuria (asymptomatic)
to macrohematuria leukocyturia Cylindrical shape
2. Hypertension: - sodium and water retention (secondary
hyperaldosteronism, decreased glomerular filtration
rate in severe CRF) - hypersensitivity to normally
functioning pressor mechanisms
3. Edematous syndrome
4. Nephritic syndrome -oliguria - hematuria - hypertension
- edema

Clinical manifestations GN
Nephrotic syndrome:
-severe proteinuria
-- edema
-- hypo-albuminemia
-- hyperlipidemia
-hyper-coagulants.
-status - hematuria
-- AG
-- oliguria
Hematuric form:
pronounced.
hematuria
-Proteinuria
- - hypertension
-- oligo-anuria
-- Hypo-of complementaria - hypo-
albuminemia
- - edema
- - pain in the stomach..
- encephalopathy

Nephritic syndrom
•NS is a manifestation of acute glomerular
inflammation, usually of a reversible nature.
Development time-from 1 day to 1-2 weeks Is
characterized by:
•Oliguria (urine output less than 400 ml/day)
Reduced GFR due to glomerular obturation by
white blood cells, cell proliferation, and
mesangial cell contractionmesangial cell contraction
Nephritic syndrom
•Characterized by: Increased reabsorption of
sodium and water; Increase in the volume of
circulating blood An increase in the volume of
extracellular fluid with the appearance of
edema The appearance of erythrocyte cylinders
in the urine, leukocyturia, proteinuria (protein
loss of less than 3.5 g/day)
Нефритический синдром
•Most often, this syndrome manifests
glomerulonephritis. The appearance of the
clinical picture of the syndrome is associated
with the deposition of immune complexes
between the basement membrane and
podocytes that provoke inflammation.
Nephritic syndrom
•Deposition of immune complexes – a
distinctive feature
•Acute infectious glomerulonephritis
•Lupus glomerulonephritis
•Glomerulonephritis in hemorrhagic vasculitis
In some cases, the nephrotic syndrome turns
into acute renal failure
Nephritic syndrom
•Hematuria, erythrocyturia (cylinders), oliguria-
are possible not only in NS, but also in
inflammation of the renal tubules and
interstitium (tubulo-interstitial nephritis).
Differences minor proteinuria
•The predominance of other proteins, not
albumin.

Nephrotic syndrom
•The syndrome is based on high proteinuria. It
develops due to the sharply increased
permeability of the glomerular filter with
damage to the basement membrane and the
filtration gaps between the podocyte legs.
Nephrotic syndrom
•High proteinuria is caused by:
Hypoalbuminemia Edema (oncotic theory of
development) An increase in the level of
cholesterol (an increase in LDL and
CHOLESTEROL in all, TG and VLDL only in
severe cases) Thrombophilia Loss of ATIII, S
and C proteins in the urine. Enhanced
synthesis of fibrinogen Increased platelet
aggregation and decreased fibrinolysis
Nephrotic syndrom
•Аnemia
–Anemia Hypochromic - loss of transferrin, does
not respond to therapy with iron preparations.
Normochromic – reduced erythropoietin
synthesis– потеря трансферрина, не подAnemia
Hypochromic - loss of transferrin, does not
respond to therapy with iron preparations.
Normochromic – reduced erythropoietin synthesis
Treatment
Salt-free diet
Antibiotici
Diuretici
Heparini
Antihypertensive drugs

mesangial cell contraction
Nephritic syndrom
•Characterized by: Increased reabsorption of
sodium and water; Increase in the volume of
circulating blood An increase in the volume of
extracellular fluid with the appearance of
edema The appearance of erythrocyte cylinders
in the urine, leukocyturia, proteinuria (protein
loss of less than 3.5 g/day)
Нефритический синдром
•Most often, this syndrome manifests
glomerulonephritis. The appearance of the
clinical picture of the syndrome is associated
with the deposition of immune complexes
between the basement membrane and
podocytes that provoke inflammation.
Nephritic syndrom
•Deposition of immune complexes – a
distinctive feature
•Acute infectious glomerulonephritis
•Lupus glomerulonephritis
•Glomerulonephritis in hemorrhagic vasculitis
In some cases, the nephrotic syndrome turns
into acute renal failure
Nephritic syndrom
•Hematuria, erythrocyturia (cylinders), oliguria-
are possible not only in NS, but also in
inflammation of the renal tubules and
interstitium (tubulo-interstitial nephritis).
Differences minor proteinuria
•The predominance of other proteins, not
albumin.

Nephrotic syndrom
•The syndrome is based on high proteinuria. It
develops due to the sharply increased
permeability of the glomerular filter with
damage to the basement membrane and the
filtration gaps between the podocyte legs.
Nephrotic syndrom
•High proteinuria is caused by:
Hypoalbuminemia Edema (oncotic theory of
development) An increase in the level of
cholesterol (an increase in LDL and
CHOLESTEROL in all, TG and VLDL only in
severe cases) Thrombophilia Loss of ATIII, S
and C proteins in the urine. Enhanced
synthesis of fibrinogen Increased platelet
aggregation and decreased fibrinolysis
Nephrotic syndrom
•Аnemia
–Anemia Hypochromic - loss of transferrin, does
not respond to therapy with iron preparations.
Normochromic – reduced erythropoietin
synthesis– потеря трансферрина, не подAnemia
Hypochromic - loss of transferrin, does not
respond to therapy with iron preparations.
Normochromic – reduced erythropoietin synthesis
Treatment
Salt-free diet
Antibiotici
Diuretici
Heparini
Antihypertensive drugs

EN ИН KIDNEY DISEASES IN CHILDREN BYJCNH 2021.pdf

About This Presentation

Slide Content

Tags

Categories

Download

Quick Actions

Statistics

Related Slideshows

EN ИН KIDNEY DISEASES IN CHILDREN BYJCNH 2021.pdf

About This Presentation

Slide Content

Slide 1

Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

Slide 7

Slide 8

Slide 9

Slide 10

Slide 11

Slide 12

Slide 13

Slide 14

Slide 15

Slide 16

Slide 17

Slide 18

Slide 19

Slide 20

Slide 21

Slide 22

Slide 23

Slide 24

Slide 25

Slide 26

Slide 27

Slide 28

Slide 29

Slide 30

Slide 31

Slide 32

Slide 33

Slide 34

Slide 35

Slide 36

Slide 37

Slide 38

Slide 39

Slide 40

Slide 41

Slide 42

Slide 43

Slide 44

Slide 45

Slide 46

Slide 47

Slide 48

Slide 49

Slide 50

Slide 51

Slide 52

Slide 53

Slide 54

Slide 55

Slide 56

Slide 57

Slide 58

Slide 59

Slide 60

Slide 61

Slide 62

Slide 63

Slide 64

Slide 65

Slide 66

Slide 67

Slide 68

Slide 69

Slide 70

Slide 71

Slide 72

Slide 73

Slide 74

Slide 75

Slide 76

Slide 77