Can proteinuria in children be cured?

When children have kidney disease, they are prone to proteinuria. Proteinuria refers to the high protein content in the urine. At this time, the urine is foamy, especially the first urine in the morning. Kidney disease in young children is very harmful and can easily lead to infection, electrolyte imbalance, and even acute renal failure in children.

1. Infection

It is the most common complication of this syndrome. The susceptible causes are: loss of IgG and complement components in the urine, decreased IgG synthesis leading to immune dysfunction; cellular immune dysfunction; protein malnutrition; edema; and use of immunosuppressants. Respiratory tract infection is the most common, followed by skin and urinary tract infections and primary peritonitis. Peritonitis is common in children with ascites. The most common pathogens are capsular bacteria (such as Streptococcus pneumoniae) and Escherichia coli. The clinical manifestations are fever, abdominal pain and distension, but abdominal muscle tension and rebound tenderness may not be significant.

2. Electrolyte imbalance

Hyponatremia: caused by long-term salt abstinence, excessive use of diuretics, infection (increased secretion of stress-induced antidiuretic hormone), diarrhea, and vomiting, manifested as anorexia, fatigue, laziness, drowsiness, low blood pressure, shock, and convulsions. Hypokalemia: caused by the use of diuretics or hormone diuresis, poor appetite, vomiting and diarrhea without considering potassium supplementation. Hypocalcemia and osteoporosis: Vitamin D binding protein is lost in the urine, resulting in decreased D levels, poor intestinal calcium absorption, decreased sensitivity of bones to the regulatory effects of parathyroid hormone, hyperparathyroidism, and the use of hormones.

3. Hypercoagulable state and thrombosis

Causes: Increased synthesis of coagulation factors in the liver; loss of anticoagulant factor III in the urine; hyperlipidemia leading to blood viscosity, slow blood flow, and increased platelet aggregation; infection or vascular wall damage activating the endogenous coagulation system; use of diuretics, reduced blood volume, and hemoconcentration; hormone use promoting hypercoagulation, etc. The most common symptoms of renal vein thrombosis are: sudden low back pain or abdominal pain, non-glomerular hematuria, oliguria, and even acute renal failure. Ultrasound may show enlargement of one or both kidneys, and thrombi in large blood vessels may be seen. In recent years, reports of pulmonary embolism are not uncommon, and there are also reports of lower limb thrombosis and cerebral embolism.

4. Adrenal crisis

Long-term use of large doses of hormones will suppress the pituitary-adrenal cortex axis. If the drug is withdrawn too quickly, suddenly discontinued, or the dosage is not increased in time when a stressful situation occurs, the child may suddenly go into shock and may die if not treated in time.

5. Acute renal failure

The possible causes include: prerenal renal failure caused by hypovolemia; severe glomerular lesions, significant proliferation, and a significant decrease in GFR; severe renal interstitial edema and protein casts blocking the renal tubules, leading to increased hydrostatic pressure in the proximal tubules and renal capsule, resulting in a decrease in effective glomerular filtration, etc.