Pediatric Nephrology

The area of pediatric nephrology covers congenital or acquired disease of the kidneys and efferent urinary tracts as well as systemic disorders affecting the kidneys.

 

 

Disease Patterns

The most frequent deformities of the human organism are kidneys and efferent urinary tracts. Urinary tract infections, voiding disorders or noctural bed-wetting can be possible symptoms. Apart from this, a non-monosymptomatic enuresis (NME) in children may occur.

Cystic kidney disorders often go hand in hand with an increase in blood pressure. High blood pressure during childhood usually is caused by arterial hypertension.

Disorders of the renal filter are called Glomerulopathy. Symptoms are: increased excretion of red blood cells (hematuria) and/or protein (proteinuria) via the urine. As the nephrotic syndrome this can ultimately lead to accumulation of fluid in tissue (edemas). Besides that nephrotic syndrome or hereditary glomerulopathies (Alport syndrome) may occur.

A disorder of the renal filter often is a reason for systemic diseases such as Purpura Schönlein-Henoch (PSH) or systemic lupus erythematodes (SLE). The hemolytic uremic syndrome (HUS) is the most common cause for kidney failure during childhood.

Tubulopathies which are often congenital disorders of the channel system lead to loss of water and body salts Calcifications (nephrocalcinosis) or kidney stones (nephrolithiasis) can be possible symptoms.

In the case of chronic renal failure the filter and detoxification function of the kidneys only perform to a limited extend.

Examination Methods

  • Physical examination
  • Measurement of height, weight and blood pressure
  • Urine screening
  • Blood tests / blodd gas analyzer
  • Digital sonography
  • Long-term blood pressure measurement
  • Langzeitblutdruckmessung
  • Pharmokokinetische Untersuchungen (bei immunsuppressiver Therapie)
  • Uroradiologische und nuklearmedizinische Diagnostik gemeinsam mit unseren Kooperationspartnern
  • Uroflowmetrie
  • Beckenboden-EMG

Therapeutic Options

Due to the broad range of kidney diseases each therapy has to match the specific disease pattern and on an individual basis.

In the case of malformation, conservative 'wait-and-see' measures are normally enough, surgery is rarely necessary.

Recurring infections of the urinary tract require prudent consideration of antibacterial therapy and prophylaxis.

In the case of voiding disorders, behavioral therapy, biofeedback and medication therapy is available. We also offer continence-training programs.

Children suffering from glomerulopathies can expect the latest standards of medication therapy.

Our family education program “Pipilotta and the kidney detective” is an integral component in the treatment of children with nephrotic syndrome.

Medication therapy, as well as a modern high blood pressure therapy is necessary in the case of chronic renal insufficiency and its secondary effects.

Care for transplant patients is mainly focused on managing the immune-suppressive therapy, striking a balance between rejection avoidance and reduction of toxicity.