Pediatric nephrologist - description, doctor’s advice:

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Published: 09/18/2020

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• What is nephrology?
• Who is a nephrologist
• Pros and cons of the profession
• What does a nephrologist treat? A pediatric nephrologist. What is the treatment for children?

What is nephrology?

Nephrology, as a therapeutic area, is aimed at studying kidney function and treating pathological changes. The first steps towards the study of nephrology in medicine were taken back in the 19th century, but nephrology as a specialty appeared only in the second half of the 20th century, an association was established and the first nephrology department was opened. After the official emergence of this area, it was necessary to introduce a separate pediatric nephrology, as cases of childhood kidney diseases became more frequent. Over the past decades, the number of renal anomalies in newborns has increased several times. It is worth noting that most often deviations in the normal functioning of the kidneys occur in regions where various industries are located.

Nephrological diseases include:

• Pyelonephritis;
• Glomerulonephritis;
• Amyloidosis;
• Nephrotic syndrome;
• ICD (urolithiasis);
• Lupus;
• Vasculitis, etc.

Often diseases occur without visible symptoms, so patients note any problems only at the stage when they have to resort to surgical intervention. It is also difficult to determine the nature of the disease due to the significant diversity of the clinical picture.

In this case, patients come with complaints of swelling (first of all, swelling of the eyelids and face is noticeable, then the limbs and torso begin to swell), pallor of the skin.

Often, with constant high blood pressure, patients rush to a cardiologist, but they are referred for a consultation with a nephrologist. Because renal hypertension also causes headache, dizziness, fatigue, noise and congestion in the ears. As mentioned above, cases of kidney diseases and pathologies are becoming more and more common in children. It can be quite difficult for a child to describe his painful sensations. Also, kidney problems can occur after various infectious diseases. If parents notice in their children, they should not hesitate to contact a nephrologist: a change in the volume of urine and frequency of urination in contrast to the usual norm; changes in the consistency, color and smell of urine; edematous condition; involuntary urination after 4-5 years; pain and pain during bowel movements and trips to the toilet; redness and swelling of the external genitalia; sediment, mucus and blood in the urine.

NEPHROLOGY

NEPHROLOGY

(Greek: nephros kidney + logos teaching) - a section of internal medicine that studies the ethpology, pathogenesis, clinical manifestations, methods of diagnosis, treatment and prevention of kidney damage. N. explores those painful forms that were discovered in 1827 - 1836. R. Bright and later received the name “Bright’s disease” or “nephritis”. At the beginning of the 20th century. clinician F. Volhard and pathologist Th. Fahr, these diseases were divided into three clinical and anatomical groups: degenerative - nephrosis, inflammatory - nephritis (recognizing the development of hron, forms only from acute) and vascular - sclerosis (benign essential hypertension and malignant nephrosclerosis). The same groups somewhat artificially included such forms as pregnancy night, sublimate kidney, amyloidosis. For a long time, this classification scheme was taken as the basis for the study of kidney diseases, although already at the beginning of the 20th century. was criticized, in particular by ^ • Konchalovsky. There was an objection to the opposition of primary degenerative changes in the tubules (nephrosis) to primary inflammatory changes in the glomeruli (nephritis), since changes in the glomerular apparatus of the kidneys were also found in the so-called. nephrosis. The term "nephrosis" was essentially dropped from use. In our country, the classification of E. M. Tareev (1958) has gained recognition, according to the cut, in addition to diffuse nephritis and dystrophic kidney lesions, acute (reversible, transient) toxic and infectious kidney lesions are distinguished.

Even in ancient times, the occurrence of general dropsy (edema) was associated with kidney diseases. K. Galen considered the cause of edema to be the inability of the kidneys to remove the “serenity” of the blood. For the first time, changes in the kidneys in an edematous patient were described by G. Morgagni in 1726, later the main wedge was discovered, a symptom of kidney disease - proteinuria, while protein excreted in the urine was detected by heating or by adding nitric acid [D. Cotugno ), 1770; Cruickshank, 1798]. This sign was considered important for distinguishing renal hydrops. However, only R. Bright for the first time (1827) established a connection between general dropsy, protein in the urine and diffuse kidney damage and described other wedges, manifestations of the disease - blood in the urine, hypoproteinemia, turbidity of the blood serum (hypercholesterolemia), cardiac hypertrophy (increased blood pressure ), increased urea content in the blood.

Domestic clinicians S. P. Botkin, A. A. Ostroumov, G. A. Zakharyin made a certain contribution to the study of the clinic, etiology and pathogenesis of kidney diseases, in particular the role of the hypertensive-ischemic factor and neurogenic effects, developed dietary and spa treatment for kidney patients . In the laboratory of S.P. Botkin, Ya.Ya. Stolnikov (1880) caused renal sclerosis and cardiac hypertrophy (arterial hypertension) by experimental renal ischemia. In area II. the works of S. S. Zimnitsky (1922) are widely known, who attached primary importance to the participation of the glomerular apparatus in the development of kidney diseases, considering, for example, lipoid nephrosis as a variant of hron, nephritis.

A better understanding of the subtle mechanisms of kidney activity was facilitated by the discovery by A. M. Shumlyansky (1792) of a cavity in the glomerulus - Shumlyansky’s capsule, and in the 20th century - micropuncture of the nephron, microchemical methods, the work of Richards (A. N. Bichards), A. Kashni, Smith (HW Smith), the discovery of the counter-flow system, the mechanisms of sodium conservation by the kidney, the shunting system in the juxtaglomerular nephrons, etc. - all that made it possible to understand physiol, the activity of the organ and to determine more reliably and simply standard indicators of function kidneys in the clinic: the value of plasma flow, glomerular filtration, etc.

Experimental research contributed greatly to the development of science. The development of immunonephrology began with the discovery by I. I. Mechnikov of nephrotoxic nephritis, which was then reproduced by Masugi (M. Masugi, 1933), under the name of which it is better known in the literature (see Cytotoxic experimental nephritis).

The name of I.I. Mechnikov is also associated with the study of cellular immunity, the role of which in the pathogenesis of kidney diseases was demonstrated much later when the cytopathic effect of lymphocytes on the culture of nephrocytes and fibroblasts in patients with lupus nephritis was detected.

Thus, N.’s isolation became possible thanks to the achievements of not only normal and patol, physiology, wedge, medicine, patol, anatomy, but also biochemistry, pharmacology, immunology, and genetics. This interpenetration is determined by the need to study the complex processes that determine the role of the kidneys in maintaining, together with intestinal enterocytes and other systems, the constancy of the internal environment of the body, in the regulation of blood circulation and hematopoiesis, carbohydrate and lipid metabolism. This ensures both autoregulation of the functioning of the kidneys themselves and the body as a whole.

In the middle of the 20th century. Therapists were faced with new problems, numerous and varied, previously unknown nozol forms, which contributed to the separation of a number of sections from internal medicine, of which N. soon gained a strong position, in many respects ahead of certain other specialties.

The high regenerative ability of the tubular epithelium with its finely differentiated activity and high energy potential puts the kidneys in special conditions in case of acute impairment of their function compared, for example, with the myocardium or liver, a severe acute lesion of which does not yet provide the opportunity to reliably and relatively simply save the patient’s life, as with hemodialysis in acute renal failure. In the monograph “Nephritis” (1958), E. M. Tareev first highlighted the chapter “Acute toxic and infectious kidney damage.” This monograph also draws attention to the fact that in patients who survived acute toxic damage to the kidneys, there was no further chronic disease or shrinkage of the kidneys, which is an important feature of these lesions.

Involvement of the kidneys in patol, the process is also observed in classical chronic metabolic, systemic, inf. diseases, diseases of the liver, pancreas. With modern hormonal replacement, immunosuppressive, anti-infective therapy, patients die not from failure of the main affected organ, but from uremia - due to prolongation of life and subsequent kidney damage; These are, for example, diabetes mellitus and diabetic glomerulosclerosis, hepatic-(pancreatic-renal) syndrome with renal failure, glomerulonephritis with systemic lupus erythematosus, prolonged septic endocarditis. This determines the need to use a variety of research methods in the diagnosis of kidney diseases, allowing one to assess changes in both the kidneys and other organs. Examination of a renal patient usually includes several stages: identification of the leading syndrome (urinary, nephrotic, hypertensive) or a set of syndromes, determination of nosole, the basis of the syndrome (differential diagnosis), assessment of the degree of activity of the renal process and function, condition of the kidneys (acute or chronic, renal failure, partial violations). At the same time, classical research methods retain their full significance - first of all, a detailed study of the anamnesis, including family history, examination, percussion, palpation, standard methods of examining urine and blood. At the same time, such special highly informative methods as X-ray (including tomography, aortography), isotope (scanning, renography), echographic examination, kidney biopsy using immunohistochemical and electron microscopic examination, etc. are being successfully introduced.

The need to use complex research methods has led to the creation of specialized nephrol departments and hemodialysis departments. The role of these departments is undoubtedly great both for the diagnosis and treatment of severe renal diseases, and for their early detection and prevention of progression. Clinical examination and systematic examination of schoolchildren entering universities, students, etc. are especially important. The practical role of hemodialysis departments is increasingly increasing, especially in acute renal failure.

Scientific research conducted by nephrologists in our country and abroad is aimed at clarifying issues of physiology and morphology of the kidneys, at solving the most important wedges, problems - problems of hron, glomerulonephritis (see), kidney damage in systemic diseases, hron, pyelonephritis (see. ), as well as pathogenesis and treatment hron. renal failure (see).

The scientific and practical activities of nephrologists in our country are coordinated by the All-Union Scientific Society of Nephrologists (VNON), which was organized in 1969; in 1974, the 1st congress was held in Minsk, and in 1980, the 2nd congress of VNON was held in Baku, at which topical issues of nephrology were discussed - the pathogenesis and treatment of kidney diseases, the organization of nephrol, services, etc. d.; 4 plenums of the VNON board, various conferences and symposiums were held.

Soviet nephrologists took part in the work of international congresses of nephrologists, which were held 6 times since 1960 (Evian, Prague, Warsaw, Stockholm, Mexico City, Florence). In 1974, the first symposium of nephrologists from socialist countries was held in Tula (USSR), where the treatment of kidney diseases, as well as further paths of modern work, were discussed in detail.

N.'s questions are studied in medicine. institutes within the framework of courses in propaedeutics, faculty and hospital therapy, further improvement of knowledge is carried out in special cycles of institutes for advanced training of doctors. Research work in the field of N. is headed by the Problem Commission of the USSR Academy of Medical Sciences, VNON, and research institutes. The main publications covering the problems of N. in the USSR are the journals Urology and Nephrology, Therapeutic Archive, Clinical Medicine, Soviet Medicine, and Pathology Archive.

Bibliography:

Botkin S.P. About diffuse inflammation of the kidneys, Ezhened. Klin, gas., No. 9, p. 129, no. 10, p. 145, 1884; In about in with and M. S. Diseases of the urinary system, M., 1960; 3 akh a r i n G. A. Clinical lectures, V. 4, M., 1894; 3 and mnitskiy S.S. A few words in defense of the kidney glomerulus, Doctor, case, No. 8, p. 629, 1925; Kerpel-Fro-n and E. Pathology and clinic of water-salt metabolism, trans. from Hungarian, Budapest, 1964; Mechnikov I.I. Cellular poisons (cytotoxins), Rus. arch. pathol., wedge, honey. i bakteriol., vol. 11, no. 2, p. 101, 1901; Natochin Yu. V. Ion-regulating function of the kidney, JI., 1976; Nikolaev P.N. Bright's disease at the present stage of its understanding, in the book: Fundamentals of modern achievements, medical, ed. A. A. Bogomolets and V. M. Kogan-Yasny, vol. 5, p. 135, Kyiv, 1938; Kidneys, ed. F. K. Mostofi and D. E. Smith, trans. from English, M., 1972; Pytel A. Ya. and Goligorsky S. D. Acute renal failure, Chisinau, 1963; Ratner M. Ya., Serov V. V. and Tomilina N. A. Renal dysfunctions, M., 1977; Sechenov I.M. Note on renal circulation, Doctor, vol. 4, no. 8, p. IZ, 1883; T apee in E. M. Anemia of brightikov, M., 1929; aka, Nephrites, M., 1958, bibliogr.; I r oshevsky A. Ya. Clinical nephrology, L., 1971, bibliogr.; In right R. Reports of medical cases selected with a view of illustrating symptoms and cure of diseases by a reference to morbid anatomy, v. 1, p. 1, L., 1827; Goldblatt H. ao Studies in experimental hypertension, The production of persistent elevation of systolic blood pressure by means of renal ischemia, J. exp. Med., v. 59, p. 347, 1934; Lindemann W. Sur le mode d'action de certains poisons renaux, Ann. Inst. Pasteur, t. 14, p. 49, 1900; M as ugi M. t)ber die experimentelle Glomerulonephritis durch das spezifische Antinie-renserum, Ein Beitrag zur Pathogenese der diffusen Glomerulonephritis, Beitr, path. Anat., Bd 92, S. 429, 1934; Reubi F. Nephrologie clinique, P., 1972; Smith HW The kidney structure and function in health and disease, NY—Oxford, 1951; Volhard F. u. Fa hr Th. Die Brightsche Nierenkrankheit (Klinik, Pathologie und Atlas), B., 1914.

E. M. Tareev, N. A. Mukhin.

Who is a nephrologist

A nephrologist is a highly specialized specialist whose area of ​​professional activity includes surgical, conservative and medicinal treatment of various pathologies, as well as acquired, chronic and related kidney diseases. Related specializations include such areas of medicine as urology, onconephrology, and gynecology. As a rule, nephrologists use radical methods of therapy, since dysfunction of the kidneys, which are the main excretory organ, can lead to the death of the patient.

Pros and cons of the profession

The obvious advantages of being a nephrologist include:

• Narrow specialization - allows you to achieve a high degree of mastery in your chosen profession.
• Possibility of foreign business trips to exchange experiences.
• Application of modern technologies and innovative treatment methods in work.
• If desired, the specialist is provided with rapid career growth.
• Nephrology is a sought-after specialty, so a residency graduate can easily find an open position.

Despite a significant number of advantages, the profession of a nephrologist also has a number of disadvantages, including:

• High degree of responsibility both at the diagnostic stage and during the treatment of the patient.
• Participation in and management of complex, multi-hour operations.
• Kidney diseases are often detected in the terminal stage, when even a qualified nephrologist is unable to help the patient.
• High stress levels.
• Long and extremely difficult specialty training.

What does a nephrologist treat?

A nephrologist primarily deals with the diagnosis and treatment of kidney diseases, which include the most common ones, such as:

• urolithiasis disease;
• nephroptosis;
• pyelonephritis;
• glomerulonephritis;
• hereditary nephropathies;
• kidney amyloidosis;
• ischemic nephropathy;
• polycystic kidney disease;
• hydronephrosis;
• acute renal failure;
• chronic renal failure;
• hepatorenal syndrome;
• oxalate nephropathy;
• urate nephropathy;
• hypertensive nephropathy;
• alcoholic nephropathy;
• the so-called “senile kidney”;
• paranephritis and much more.

Pediatric nephrologist. What is the treatment for children?

A pediatric nephrologist is a doctor who diagnoses, treats, and prevents kidney diseases in children of all ages and corrects abnormalities of the renal apparatus while the baby is in the womb.

It is necessary to make an appointment with a pediatric nephrologist if your child has symptoms:

• swelling in any form;
• frequent urination, accompanied by pain;
• severe redness of the genitals;
• severe pain in the lower back, lower abdomen;
• change in smell, color of urine;
• admixture of blood, protein, mucus in urine;
• a significant increase or decrease in the excreted portion of urine;
• bedwetting in a child over 4 years old.

It is not easy to suspect kidney problems in young children; they cannot say what is bothering them. Therefore, parents should be vigilant and pay attention to the baby’s condition.

If he cries during urination, is irritable, and the color and smell of urine has changed, then you need to contact a nephrologist. A pediatric nephrologist is able to diagnose and treat diseases:

• jades;
• familial nephropathies;
• urolithiasis;
• renal failure;
• enuresis;
• kidney dysplasia;
• abnormal structure of the organs of the urinary system.

You can learn more about pediatric nephrology: diagnosis, treatment and prevention of kidney diseases from the video:

Therapy for kidney diseases in a child is selected individually, taking into account many factors. If the pathology is inflammatory in nature, then the nephrologist prescribes a course of antibiotics. A dietary menu and a program of preventive measures are being drawn up.

What diseases does a pediatric nephrologist treat?

It should be understood that a child’s body functions differently than an adult’s. In this regard, there are childhood kidney diseases that practically do not occur in people at a more mature age.

What does a pediatric nephrologist treat? Below we provide a small list of problems that a pediatric nephrologist treats.

• Children's pyelonephritis is an inflammation of the kidneys, which has a bacterial etiology, characterized by damage to the calyces, pelvis and parenchyma;
• Childhood glomerulonephritis is a disease in which the glomeruli become inflamed;
• Tubolopathies are a group of diseases characterized by impaired functioning of the renal tubules;
• Familial nephropathies;
• Urinary incontinence, urinary incontinence, enuresis (bedwetting);
• Kidney dysplasia is a pathological development of the genitourinary system in newborns, characterized by a reduced size of one or two kidneys at once and the phenomena arising from this pathology;
• Anomalies of the urinary system;
• Hydronephrosis is kidney damage that occurs due to abnormal narrowing of the ureters, which makes it difficult for urine to pass to the bladder;
• Hemolytic-uremic syndrome is a combination of renal failure (acute) with thrombocytopenia and hemolytic anemia;
• Nephritis against the background of hemorrhagic vasculitis;
• Dysmetabolic nephropathy is a group of diseases caused by metabolic disorders;
• Pathology of the renal pelvis. This disease appears in young children due to impaired age-related narrowing of the renal pelvis. As a rule, at the age of up to six months, the renal pelvis is dilated and this is the norm, but after the child reaches six months, they narrow;

It should be understood that a nephrologist treats the same diseases in newborns that are included in the above list, however, congenital pathologies of the ureters and kidneys (hypoplasia, aplasia, dystopia, narrowing or expansion of the ureters, etc.) are more common in babies. With some pathologies (for example, with Potter's syndrome), the child does not survive, since he has no kidneys at all.

Having found out what a nephrologist treats for children, let’s look at how an appointment with this specialist goes.

Our service will select the best nephrologist for you for free when you call our Unified Appointment Center by phone. We will find an experienced doctor near you, and the price will be lower than if you contact the clinic directly.

Alarming symptoms: how to recognize?

A kidney doctor can detect certain prerequisites for kidney pathology. He recognizes as alarming signs such as pain in the lumbar region, the presence of blood or protein in the urine, increased levels of creatinine and leukocytes, and swelling. The diagnostic process is significantly complicated by the fact that in most cases the disease proceeds without manifesting itself in any way, and it can only be detected when it is no longer possible to do without the intervention of a surgeon. In addition, advanced kidney problems in most cases lead to serious complications on the cardiovascular system.

To prevent this from happening, you need to treat the condition of your body with the utmost care and seek qualified medical help if you have the following signs:

1. Anuria is the absence of healthy urination. This can happen both due to insufficient flow of urine into the bladder, and due to its complete absence, which is an indicator of a malfunction of the organs. In this state, excess fluid is either not excreted at all, or is excreted, but in too small an amount. As a result, venous congestion occurs, intoxication of the body occurs, and the load on the heart increases significantly.
2. Oliguria is insufficient urine output (about 500 ml instead of 1.5 liters according to the norm for a healthy person). Diuresis at night increases, as does the activity of the cardiovascular system.
3. Polyuria is frequent urination, which is characterized by excessive secretion of excess fluid (up to 3 liters per day). The reasons can be both external - excessive consumption of drinks that stimulate the formation of urine, and internal - disturbances in the endocrine system and renal failure.
4. Pain that is localized in the lower back, on one or both sides.
5. Presence of protein in the urine.
6. High blood pressure.

If there are relevant complaints, the doctor should also deal with renal colic, infections of the urinary system, chronic or acute renal failure, and acute inflammatory processes.

When to see a nephrologist

Regular visits to a nephrologist are provided for persons who have suffered from the following diseases:

• Impaired urine outflow, accompanied by acute pain;
• Destabilization of kidney function;
• Inflammation of the paired bean-shaped organ;
• Infections of the urinary system;

If you have the following symptoms, you should visit a nephrologist as soon as possible.

• Pain during the natural process of urination;
• Producing an excessively large volume of urine during urination (polyuria);
• Problems with urination, cessation of urine output (anuria);
• Acquisition of unnatural color in urine, turbidity;
• Detection of blood clots, blood, mucus in the urine;
• Pain in the lumbar region that does not have any obvious cause. Pain may radiate to the hip joint;
• The appearance of swelling (in particular in women during pregnancy);
• Change in the smell of urine, unpleasant odor of urine;

Signs of kidney disease in children

Adults more or less adequately respond to the first symptoms indicating that their kidneys are not entirely in order. Things are worse with children. They won't always notice that something has changed, or they can't even tell about it yet. For this reason, parents need to be as careful as possible.

As mentioned earlier, changes in the color and smell of urine, its cloudiness are the first reason for the child to be seen by a nephrologist. We already know what the doctor treats. Delay in filing can be very costly.

Children often identify pain in the lumbar region and lower abdomen as a sore stomach. Therefore, it is worth checking this by lightly pressing on the lower back, first on one side, then on the other side of the spine. If it causes pain, it means there is a problem with the kidneys.

A sharp, causeless increase in temperature of several degrees without other cold symptoms can be evidence of inflammatory processes in the kidneys and urinary tract. In this case, you also need to rush to a nephrologist.

Preparing before going to the nephrologist

At your first appointment with a nephrologist, you need to bring a medical card and the results of a general urine and blood test. It is recommended to remember previous illnesses before the consultation. Talk about the medications you have taken recently. Since the kidneys affect blood pressure, you need to take blood pressure measurements and record the readings before seeing a doctor.

Preparing for a visit to a nephrologist consists of the following points:

• 12 hours before your scheduled appointment, you should not eat;
• It is prohibited to smoke and drink alcohol 12 hours before visiting the doctor;
• Drink a small amount of liquid in the evening;
• Stop taking medications the day before, if possible.

Women should remember how pregnancy and childbirth went, whether there were any complications or problems. Preparation before going to the nephrologist is a stage on which the accuracy of the diagnosis depends; do not neglect the rules.

When to consult a nephrologist?

Kidney diseases, especially in the initial stages of development, are asymptomatic, which makes diagnosing the disease difficult. In order not to start a pathological process that can lead to complications, it is necessary to take a urine test. Thanks to this, problems can be detected at an early stage. Contact a nephrologist immediately if symptoms appear:

• persistent hypertension;
• intense pain in the lower back, which only increases;
• change in the color or smell of urine;
• hematuria and renal colic;
• painful urination;
• swelling of the body during pregnancy;
• protein impurities in the urine;
• complete absence of urine;
• a significant increase in the amount of urine or its decrease.

If symptoms occur, you need to quickly see a nephrologist. This should be done especially if, along with all the symptoms, there is hyperthermia.

How does an appointment with a nephrologist proceed?

When you come for a consultation, the nephrologist will ask you questions about your general health, the presence of other diseases, your complaints, and the health of your close relatives. Bad habits, frequent use of painkillers, increased blood pressure - you will be asked about this too. After the conversation, the doctor will conduct a general examination and measure your blood pressure. After this, the specialist will prescribe an additional examination and invite you for a second appointment.

How to prepare for a doctor's appointment

A few simple rules will help you get the most out of your visit to the doctor, and help a specialist make a diagnosis faster.

1. Write down your questions in clear handwriting on a piece of paper in advance. Give the sheet to the doctor at your appointment. This will help you remember to ask questions that are important to you and get answers from a professional.
2. Prepare and take with you all tests and examinations, make bookmarks in your medical record with colored stickers to make them easier to find during the consultation.
3. Before your visit, it is better to keep a diary of your blood pressure and pulse for several days; take the diary with you to the consultation.
4. Write a separate list of all the medications you take, indicating the dosages, and take them with you to your appointment.

Pediatric nephrologist - description, doctor’s advice:

E Zh Ts Sh Shch Yu Ya

Children's doctors

• Who is a Pediatric Nephrologist?
• What is the competence of a Pediatric Nephrologist?
• What diseases does the Pediatric Nephrologist treat?
• What organs does a pediatric nephrologist deal with?
• When should you contact a pediatric nephrologist?
• When and what tests should be done
• What are the main types of diagnostics usually performed by a pediatric nephrologist?
• Advice from a pediatric nephrologist
• Sign up for an appointment with the doctor

Who is a Pediatric Nephrologist?

Engaged in the diagnosis, treatment and prevention of kidney diseases. As a rule, a nephrologist is contacted after abnormalities are detected in the tests - pathological levels of protein, blood cells, salts, etc. in the urine. Depending on the patient’s condition, the nephrologist will prescribe additional tests and examinations. In addition, a nephrologist treats congenital abnormalities of the kidneys.

What is the competence of a pediatric nephrologist?

A pediatric nephrologist is a pediatrician who has completed a course in the discipline “nephrology of childhood” and deals with the diagnosis, treatment and prevention of diseases of the urinary system in children.

What diseases does the Pediatric Nephrologist treat?

In the modern understanding, pediatric nephrology is based on the general principles of pediatrics. Nephrology of childhood studies homeostasis, its renal regulation in a healthy child at different age stages of its development, as well as disturbances of homeostasis associated with diseases of the urinary system, which can arise during the development of a person. Diseases: - Children's pyelonephritis. - Glomerulonephritis. — Dysmetabolic nephropathy, including urolithiasis. — Interstitial (abacterial) nephritis. — Anatomical abnormalities of the urinary system. — Familial nephropathies (without morphological specification). — Hereditary nephritis; - Kidney dysplasia. - Tubulopathies. — Nephritis with hemorrhagic vasculitis. — Nephritis in systemic connective tissue diseases. — Hemolytic-uremic syndrome» />Hemolytic-uremic syndrome.

What organs does a pediatric nephrologist deal with?

Kidneys, ureters, bladder, urethra, penis.

When should you contact a pediatric nephrologist?

A nephrologist is contacted in the following cases: - a child complains of pain when urinating; - frequent urination; — abnormalities in urine tests are observed against the background of ARVI; — deviations from the norm were found during ultrasound diagnostics of the kidneys and bladder, etc.

When and what tests should be done

It is necessary to take the following tests: - general urine test; — urine culture for bacteriuria; — urine analysis according to Nechiporenko; — studies of the functional capacity of the kidneys; — chromocystoscopy; — analysis of secretions from the urethra of the prostate gland, ejaculate.

What are the main types of diagnostics usually performed by a pediatric nephrologist?

The following instrumental examination methods are performed: — Radioisotope renography. — Excretory urography. - Vaccine cystography. — Renal angiography and tomography. - Vaccine cystourethrography. - Ultrasound.

Advice from a pediatric nephrologist

It cannot be said that by observing certain measures, you can completely insure your child against diseases of the urinary system. This would not be true. But identifying the pathology in time (and, therefore, starting treatment on time) to prevent possible unpleasant complications is very important. To do this, you need the following: - be attentive to the child’s condition, noting possible signs of the disease; — do not neglect preventive examinations by a pediatrician (remember that children under one year are examined every month, from one to three years old - every three months, from three to seven years old - every six months); — do not allow the child to become hypothermic (do not allow him to sit on cold ground, stones, swim in cold water, etc.); - breastfeed your baby as long as possible - such children are less likely to develop intestinal dysbiosis (dysbacteriosis), which means there is less chance of pathogens from the intestines entering the urinary system with the subsequent development of a urinary tract infection. In addition, breastfed children have a higher level of immunoglobulin A in their urine, which provides local protection of the urinary tract from infectious agents; - if a child has a high fever and there are no other signs of illness (runny nose, cough, etc.), be sure to call a doctor (do not self-medicate).

Is something bothering you? Do you have questions or need an inspection? You can make an appointment with a Pediatric Nephrologist by choosing the clinic that is most suitable for you in the “All Medicine” section. For any other questions, the Euro lab is always at your service! The best doctors will examine you, advise you, provide the necessary assistance and make a diagnosis. Euro lab clinic is open for you around the clock.

How to contact the clinic: Phone number of our clinic in Kiev: (+38 (multi-channel). The clinic secretary will select a convenient day and time for you to visit the doctor. Our coordinates and directions are listed here. Look in more detail about all the clinic’s services on its personal page.

If you have previously performed any tests, be sure to take their results for a consultation with a Pediatric Nephrologist. If the studies have not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

It is necessary to take a very careful approach to your overall health. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. To do this, you simply need to be examined several times a year by a pediatric nephrologist in order not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the organism as a whole.

If you want to see a doctor, use the online consultation section, perhaps you will find answers to your questions there and read the advice of a Pediatric Nephrologist on self-care . If you are interested in reviews of clinics and doctors, try to find the information you need on the forum - perhaps after that you will no longer be bothered by the question “ recommend a good pediatric nephrologist .” Also register on the Euro lab to be constantly aware of the latest news and updates on the site, which will be automatically sent to you by email.
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How is the examination carried out?

A nephrologist always uses laboratory tests to diagnose and monitor the effectiveness of treatment.

• general urine analysis - reaction, density, protein, glucose and formed elements - using these indicators, the doctor evaluates the quality of urine, and therefore the functioning of the kidneys;
• Urinalysis according to Nechiporenko reflects the number of red blood cells and leukocytes in the urine;
• complete blood count to detect inflammation and anemia;
• biochemical blood test to determine creatinine (the main indicator of kidney function), urea, uric acid;
• renal function tests (Zimnitsky and Reberg).

The results of functional tests allow us to draw conclusions about how well the kidneys perform their main function - they cleanse the blood and remove metabolic products.

Necessary primary tests

To make a correct diagnosis, laboratory diagnostics of diseases is developed in clinics where a nephrologist is seen. The first tests that patients with suspected nephrological diseases undergo are a general assessment of the composition of the urine. Any deviations from the norm indicate that there is cause for concern and further research.

A more complete picture of kidney function is provided by daily urine collection. It shows the state of these organs throughout the day, whether malfunctions occur in their work, and at what time this occurs.

Urine culture to identify harmful bacteria shows the nature of the disease. If microorganisms are detected, then we can talk about viral or bacterial inflammation, for the treatment of which special therapy is used.

Someone thinks: “Nephrologist - what does he treat? Only kidneys, he has a very narrow specialization.” In fact, his area of ​​expertise may also include more complex systemic diseases. Thus, blood tests show not only malfunctions of the kidneys or adrenal glands, but can also be evidence of serious cardiovascular diseases. Everyone knows that adrenaline affects the heart rate, and it is produced precisely in the adrenal glands, which are the competence of the nephrologist. Therefore, he always looks at a general blood test and the results of a special study for electrolytes and the presence of urea and salts in the blood plasma.

What tests should be taken when visiting a nephrologist?

During the patient’s appointment, the nephrologist prescribes an examination that will help establish the diagnosis of the disease, its course and severity with maximum accuracy. This is necessary in order to prescribe optimal treatment based on the results of the examination, which will help get rid of problems associated with various disorders and malfunctions of the kidneys.

Often, before visiting a nephrologist, many people are interested in the question: “What tests should be taken when visiting a nephrologist?” Of course, to establish the main causes of kidney disease, in addition to the medical history, test results are needed. Laboratory tests are assessed by urea level, ESR, creatinine, electrolytes, urinolysis results, C-reactive protein (CRP) analysis, and urinalysis. 24-hour urine samples can provide reliable information about the level of kidney function, filtering capacity, and protein loss that occurs during the development of some kidney diseases.

Other medical tests and tests often ordered by your nephrologist include:

• biochemical blood/urine test;
• Ultrasound of the kidneys, urinary tract and abdominal organs;
• kidney computed tomography (CT);
• X-ray examination of the kidneys;
• kidney biopsy;
• magnetic resonance imaging of the kidneys (MRI);
• ophthalmoscopy (examination of the fundus of the eye);
• scintigraphy (radionuclide medicine);
• angiographic examination for vascular lesions;
• excretory urography and urine culture;
• radioisotope study of the kidneys.

The nephrologist himself determines the need for the patient to undergo laboratory tests, depending on the severe symptoms and characteristics of the course of the renal disease. That is, in each individual case, the doctor will select the most optimal tests and analyzes to accurately determine the diagnosis of the disease.

Diagnostic methods used by urologists and nephrologists

The first thing both a nephrologist and a urologist prescribe is blood and urine tests. This is one of the most effective ways to determine whether a person has any diseases of the genitourinary system.

Various instrumental and hardware studies can also be carried out:

1. Angiography (X-ray) of the kidneys.
2. Ultrasound examination (ultrasound) or magnetic resonance imaging (MRI) of the kidneys, bladder, and other organs that are located in the area under study.
3. Computed tomography (CT).
4. Excretory urography of the kidneys, ureters, bladder - x-ray in combination with the introduction of contrast agents into the vein.
5. Cystoscopy of the bladder is an endoscopic examination of the organ, which can be combined with simultaneous biopsy or drug administration. It is performed by inserting an endoscope into the patient's urethra.
6. Scintigraphy (radionuclide examination).

The purpose of certain studies depends on the nature of the disease being diagnosed and the technical capabilities of the clinic.

What tests does a kidney doctor order?

After consultation, the patient must be sent for examination if there are alarming symptoms. There are a number of concomitant diseases that also require careful examination and observation by a nephrologist.

Tests are prescribed by a doctor to determine the level of a number of indicators. First of all, pay attention to the results of a general blood and urine test, which report the rate of erythrocyte sedimentation.

There are also a number of tests that show the level of elements such as:

• Creatinine;
• Phosphate;
• Electrolyte;
• Calcium.

Further, to make a more accurate diagnosis, they resort to other examinations. Using angiography, the condition of the vessels, the speed of blood flow and their location are examined. Two weeks before the scheduled examination, you must avoid alcohol, undergo an ECG and fluorography. To reduce the toxicity of drugs on the body, increase the volume of fluid 2 days “before” and “after”. Before the procedure, a radiopaque contrast agent is injected directly into the abdominal aorta, and then a series of photographs are taken. Angiography helps to make an accurate diagnosis when the clinical picture is unclear.

Kidney ultrasound is a fairly simple and harmless procedure. Using this study, urolithiasis, tumors, cysts and others are detected. Computed tomography of the kidneys and adrenal glands is quite safe, however, quite expensive. It is performed both with and without a contrast agent, so contraindications depend on the patient’s allergic reactions to the substance. Also, pregnancy and diabetes will be reasons for refusing a CT scan. Indications for CT scans usually include infectious diseases, various tumors, and congenital anomalies.

Magnetic resonance imaging works on the principle of reading the characteristics of atoms. The process can last from half an hour to an hour. These studies will inform the nephrologist about the structure of the kidney tissue and the location of the kidneys, and will also show various pathologies. A kidney biopsy is the most effective way to find out about an existing disease. A sample of kidney tissue is taken from the patient with a special needle, and then a specialist performs laboratory tests on the resulting material.

Urologist or nephrologist?

Both of these specialists deal with kidney diseases: a nephrologist and a urologist. So which one should you contact? Urology is a surgical specialty, so urologists deal primarily with diseases that may require surgical treatment - tumors, urolithiasis, developmental anomalies of the urinary system, renal tuberculosis, etc. Nephrology is a branch of therapy, so the area of ​​interest of nephrologists is kidney diseases, requiring a therapeutic approach and conservative treatment. The division into nephrological and urological diseases is not entirely appropriate, since urolithiasis in the early stages can be treated by a urologist, a nephrologist, and a local therapist: with a special diet and stone-dissolving drugs. But with large stones and the ineffectiveness of conservative treatment, frequent pyelonephritis, a urologist is needed to crush or remove stones.

At the same time, preserving kidney function in urological diseases and nephroprotective therapy is one of the most important areas of work for a nephrologist. The nephrologist determines the need for renal replacement therapy (dialysis or transplantation). In some cases, some of the nephrologist’s tasks may be taken over by a general practitioner.

Nephrologist treatment methods

At the first appointment, the specialist questions the patient about the presence of complaints, collects the patient’s medical history, and considers the likelihood of a genetic predisposition to kidney disease. Then an examination is carried out, after which the nephrologist prescribes tests, in particular various urine tests.

Based on the test results, the doctor may, if necessary, refer the patient for additional examinations, such as kidney ultrasound or retrograde pyelography.

The nephrologist selects the treatment method based on the stage of development of the disease, the presence of ailments, and the individual characteristics of the patient. But therapy for kidney disease can have 2 directions: nephroprotective treatment, used for any kidney disease, or specialized treatment aimed at getting rid of the problem.

Renal pathologies are treated with a combination treatment method, which includes taking medications:

• antispasmodics: No-Shpa, Papaverine;
• painkillers: Diclofenac, Ibuprofen;
• antiseptics;
• antibiotics;
• anti-inflammatory, antifungal drugs;
• glucocorticosteroids.

More often, the doctor prescribes diuretics that help fluid leave the body, and medications that dissolve and remove kidney stones. Regardless of the disease, the selection of medications and their dosage should be carried out by a qualified nephrologist.

Many medications are not compatible with each other, and self-medication can aggravate the condition. In addition to taking medications, you will need to follow a diet, and your doctor may also recommend folk remedies.

What medications does the nephrologist prescribe?

Kidney diseases usually require a combination of treatments. These include antispasmodics, diuretics, antiseptics, and other drugs. Any prescriptions should be made only by a doctor, because in each case different combinations of drugs and their dosage are needed. In addition, many medications are not compatible with each other.

For kidney disease, a nephrologist may prescribe antispasmodics. The most popular and effective drugs are:

• drotaverine (no-shpa);
• halidor;
• papaverine.

What happens at an appointment with a nephrologist?

During a consultation with a nephrologist, the doctor interviews the patient and determines whether he has symptoms of kidney disease. The nephrologist may ask questions about the presence of urinary system diseases among the patient’s relatives in order to identify a hereditary predisposition to renal pathologies. It is also necessary to inform the specialist about the place and nature of the work (to exclude pathologies associated with intoxication of the body), weight and date of birth (nephrons that make up the kidneys are finally formed in the last stages of pregnancy), data on diuresis and blood pressure level.

What diseases do a urologist and nephrologist treat in women, men, pregnant women and children: a list of diseases

Since these doctors have slightly different specializations, they treat different diseases.

Let's start with the urologist.

It must be said right away that today there are such areas of urology: children's, women's, men's and geriatric (treatment of urological ailments in older people).

A pediatric urologist treats the following diseases in children:

• Cystitis
• Hydronephrosis
• Urea exstrophy
• Various defects of the genital organ, which can be either congenital or acquired
• Hypospadias
• Cysts on the testicles, appendages
• Tumors, both benign and malignant
• Phimosis
• Incontinence
• Cryptorchidism
• Hydrocele
• Other ailments of the genitals and scrotum

For pregnant girls and women, this specialist treats:

• Inflammation of the bladder
• Inflammation of the urethra
• Incontinence
• Bladder stones
• Tissue changes in the genital area

Regarding pregnant women, I would like to say the following: a visit to a specialist such as a urologist is absolutely not necessary if they are in good condition. However, if before pregnancy a woman suffered from urological diseases, then even their absence at the moment does not exclude the need to visit such a specialist.

Since a urologist is considered to be a “male” doctor, the largest list of ailments that are treated by this specialist is specifically for representatives of the stronger sex:

• Prostatitis – inflammation of the prostate
• Adenoma is a benign tumor of the glandular epithelium
• Urolithiasis
• Impotence – expressed in the inability to use one’s genitals for their intended purpose due to a decrease or complete disappearance of their activity
• Hydrocele
• Cystitis
• Varicocele is a venous disease of the male reproductive system.
• Urethritis is an inflammatory disease of the urethra
• Candilomatosis - growths in the form of warts that form on the anus

Now let's move on to the ailments that a nephrologist treats.

Attending doctor

A pediatric nephrologist treats the following diseases:

• Kidney dysplasia, that is, underdevelopment of this organ
• Dysmetabolic nephropathy is a kidney disease that appears due to metabolic disorders
• Tubulopathy is a severe disease that results in dysfunction of the renal tubules.
• Pyelonephritis, which is typical for children
• Glomerulonephritis is a kidney disease that affects the glomeruli of the kidneys

Women and men are treated by these specialists for the following diseases:

• Kidney failure
• Nephropathy (drug-induced)
• Hydronephrosis
• Amyloidosis
• Polycystic kidney disease
• Stones in the kidneys
• Pyelonephritis

Recommendations of a nephrologist

In most cases, nephrological diseases are completely avoidable. For these purposes, it is worth paying attention to the following recommendations of nephrologists:

• limit the content of fatty, salty, fried, smoked foods in the diet;
• maintain a drinking regime, consuming about 3 liters of liquid throughout the day;
• include foods rich in plant fiber in your daily menu - vegetables, fruits, herbs;
• avoid hypothermia;
• When the first warning symptoms appear, consult a doctor without self-medicating.

Preventive examinations are of great importance to identify renal pathologies and begin timely treatment in the early stages of the development of the pathological process before the manifestation of characteristic symptoms.

Children should visit a therapist and undergo tests at least once every 6 months; adults should undergo examinations once a year. If there are deviations in the test results, the therapist will refer the patient to a highly specialized specialist - a nephrologist.