Areas of interest
Pediatric nephrology is the branch of science related to diseases of the kidney and urinary system. Diseases such as tubular and glomerular diseases of the kidney, urinary tract infections, urinary incontinence during the day or night, kidney stones, kidney failure, nephritis are the main issues.
Urinary tract infection
During and night. urinary incontinence
Antenatal hydronephrosis (kidney enlargement detected in the womb)
Newborn kidney problems
Kidney and urinary tract stone diseases
Vesicoureteral reflux
Ureteropelvic stenosis
Kidney cysts
Kidney failure
Familial Mediterranean fever
Henoch Schonlein vasculitis
Other Vasculitides
Hematuria (presence of blood in the urine)
Proteinuria (presence of protein in the urine)
Nephrotic syndrome
Nephritis
WHAT IS PEDIATRIC NEPHROLOGY?
It is one of the sub-branches of the department of pediatric health and diseases. The department of pediatric nephrology diagnoses and treats kidney and urinary system diseases in children between the ages of 0-18. Kidneys are one of the most important organs that enable the body to be purified from toxins. They carry out their functions of balancing water, salt, acid and base in our body, excreting harmful substances through urine, and maintaining the healthy function of the body as a whole. The urinary system continues with the kidneys, ureters, bladder and urethra. Pediatric nephrologists provide protection from kidney and urinary system diseases, treatment of diseases, and taking necessary precautions to prevent recurrence.
WHO IS A PEDIATRIC NEPHROLOGIST?
He is a physician who received subspecialty training in pediatric nephrology after training in child health and diseases. Pediatric nephrologists detect congenital or acquired kidney and urinary system diseases, prevent their recurrence, and prevent irreversible damage such as kidney failure.
WHAT IS URINARY TRACT INFECTION?
HOW DO I KNOW IF MY CHILD HAS A URINARY TRACT INFECTION?
Urinary tract infection is the presence of microorganisms in the kidneys and urinary tract, which should normally be clean.
Urinary tract infection It is the second most common type of infection in children after upper respiratory tract infections.
You can understand it by frequent urination, burning during urination, fever, abdominal and side pain, nausea, vomiting, and foul-smelling urine. Fever may be the only symptom during infancy.
Continuous recurring infection may pose a risk for the kidneys, and underlying conditions such as obstruction, presence of stones, and urine leakage (vesicoureteral reflux) should be investigated.
It is very important to start appropriate treatment early in patients with urinary tract infection to prevent permanent damage to the kidneys.
WHAT IS PROTEINURIA?
Protein muscle It is an important nutrient that helps structure, tissue repair and fight infection. However, protein can be found in the blood, not in the urine. When it is found in the urine, it is called proteinuria. It may be due to a simple reason such as fever, or it may be a sign of a serious kidney disease.
It is usually treated with diet and medication. However, in some cases, a kidney biopsy is required.
WHAT IS NEPHROTIC SYNDROME?
It occurs when the proteins necessary for the body are excreted with the urine during the filtering process carried out by the kidneys, in other words, when the kidneys fail to function. It manifests itself with symptoms such as swelling in the legs and eyelids, weight gain due to water retention, and hypertension. There may be many causes of nephrotic syndrome, which is caused by inflammation in the kidney tissue. For diagnosis, blood and urine tests as well as kidney biopsy are performed. Once the underlying causes are revealed, appropriate treatment is arranged.
NIGHT BED WETTING
It is a condition we encounter very frequently in childhood. It may be caused by genetic factors, arousal disorders, and hormonal factors. The good news is that 98% are not malignant. The addition of medications to the treatment is usually around the age of five.
DAY AND NIGHT URINARY INCONTINENCE
It is most often due to low bladder capacity and is caused by dribbling during the day, frequent urination, needing to go to the toilet. It can be seen as failure to catch up. Rarely, it may also be of neurogenic or anatomical origin. In the case of lazy bladder, there is an overly enlarged bladder. He has become insensitive to illness. In some patients, fecal incontinence accompanying urinary incontinence may also be observed. This condition is due to neurological dysfunction of the bladder and intestines.
We make the diagnosis through history, urinalysis, ultrasonography, and voiding volume chart and treat the child successfully and easily.
WHAT ARE THE SYMPTOMS OF KIDNEY STONE IN CHILDREN?
In older children, side pain, pain on one or both sides of the abdomen, groin pain, blood in the urine, nausea, vomiting. However, in young children and babies, we may see a pink-red color change in the crying diaper. Urinary tract infection frequently accompanies patients with stones.
In kidney and urinary system stones, metabolic tests are performed to determine why stones develop and appropriate treatment helps to reduce the size of the stone and prevent its recurrence. In some cases, depending on the size and location of the stone, it may be necessary to break the stone.
WHAT DOES HEMATURIA MEAN?
It is the appearance of blood in the urine. Sometimes it can be seen with the naked eye, while sometimes it is only detected under a microscope. It has many causes, ranging from urinary tract infection, sand casting and stone disease to inflammation in the kidney tissue, that is, nephritis. In some cases, it may be necessary to perform a kidney biopsy. A diagnosis is made by investigation, and appropriate treatment is planned according to the diagnosis.
WHAT IS VESICOURETHRAL REFLUX, HOW IS IT TREATED?
VUR, that is, vesicourethral reflux, is the faulty return of urine to the kidney due to the structural defect at the point where the urinary tract opens to the urinary bladder. is to escape. It is treated with medication or endoscopic surgery.
WHAT ARE THE KIDNEY PROBLEMS ENCOUNTERED IN THE BABY DURING PREGNANCY?
The kidney functions of the fetus in the womb are covered by the mother. The urine produced by the baby forms the fluid in which the baby swims in the womb, called amniotic fluid. This fluid fills the baby's lungs and digestive system, playing a key role in the development of these areas. If the baby's kidneys fail, amniotic fluid will not fill the lungs and the baby will die shortly after birth. In some cases, the urinary tract is narrow in the womb. Diseases such as vomiting, vesicoureteral reflux and kidney cysts may occur.
After the gynecologist identifies these problems, the child should be monitored by a nephrologist and treated before kidney functions deteriorate.
DOES HIGH BLOOD PRESSURE HAPPEN IN CHILDREN?
Yes… It is seen three times more especially in obese children. Blood pressure should definitely be measured during well-child checks. The causes of hypertension are divided into two: primary and secondary. While primary hypertension is hypertension of unknown cause, secondary hypertension can develop due to many different factors such as kidney and heart diseases, hormonal and neurological diseases, and drug use. Once the cause of hypertension is fully determined, appropriate treatment is planned.
WHAT IS URETEROPELVIC STENCY?
Ureteropelvic stenosis, defined as stenosis in the urinary tract, disrupts the structure of the kidney by making it difficult to excrete urine from the kidney. Ureteropelvic stenosis can also be detected in babies in the womb during routine checks. The baby is followed up, taking into account the possibility of spontaneous recovery of this situation. The aim of treatment is to prevent kidney damage. There may be conditions that need to be treated with endoscopic surgery.
URINE EXAMINATION
Urinary examination is required to investigate and diagnose kidney and urinary tract diseases in children. Urine should be obtained in appropriate conditions for urine examination and culture. Obtaining a proper urine sample, especially in infants, is not an easy task.
In children, urine is obtained by four methods:
By inserting a urine bag
Collecting midstream urine
Probe (with catheter)
Obtaining urine with syringe (suprapubic aspiration)
Urinary bladder method:
It is a method used in babies who do not yet have urinary control, especially in outpatient patients. Urine can be collected with a bag for the initial urine examination (full urinalysis), but taking a urine culture is not a reliable method. Because, due to externally transmitted microbes (contamination), there is an 85% rate of pseudo-microbial growth even though there is no real infection. ur. For this reason, it is more accurate to take a urine culture using the catheter or syringe method for urine culture in babies who have a high probability of having a urinary tract infection based on the patient's complaints and findings and a complete urinalysis. In cases where there are no conditions for urine culture to be taken with the catheter and syringe method and it is necessary to use the urine bag method, following some rules increases the probability of culture accuracy. the person washes his hands properly with soap. Hands are expected to dry naturally in the air.
The baby is laid on its back in a suitable place. First, the genital areas, skin folds, anus and its surroundings are washed and wiped with sterile gauze (pads) and soap and water. It is left to air dry on its own.
The urine bag is removed from its protective cover. The part above the adhesive part is removed from the adhesive part. In girls, the skin folds are stretched and the vagina is made visible. The adhesive part of the bladder is glued first, starting from the vagina-anus area, paying attention to sticking the narrow part of the bladder between the vagina and anus, and then the other parts of the bag are glued from bottom to top. On the contrary, for a male child, it is glued from top to bottom so that the child's penis remains inside the bag.
Babies should be kept in an upright position after the bladder is inserted.
Urination cannot be obtained within 30 minutes after the bladder is inserted. If so, the bag should not be left waiting any longer and should be replaced. Meanwhile, stroking the baby's coccyx-waist area may facilitate urine intake. In the meantime, dehydration should be prevented instead of giving the baby too much liquid.
Midstream urine collection:
This is the preferred method in children with urinary control. It has high reliability when applied correctly. The genital areas of girls and boys are thoroughly cleaned with soap and water. The urine to be collected should not touch the skin or any other place in the genital area. For this purpose, the vaginal leaves are opened and stretched in girls; In boys, the foreskin is retracted; kids start peeing and
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