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Scarring disturbs the filtering process of the kidneys and allows protein to leak from the blood into the urine. However, glomerulosclerosis is one of many causes of proteinuria. A kidney biopsy (the removal of a tiny part of the kidney with a needle) may be necessary to determine whether a patient has glomerulosclerosis or another kidney problem.
Focal segmental glomerulosclerosis (FSGS) is a histopathologic finding of scarring of glomeruli and damage to renal podocytes. [2] [3] This process damages the filtration function of the kidney, resulting in protein presence in the urine due to protein loss. [3]
The aim of treatment is to reduce renal scarring. Those children with grade II or worse should receive low dose prophylactic antibiotics (Nitrofurantoin, trimethoprim, cotrimoxazole, cefalexin in those with CRF). Hypertension should be managed with ACE inhibitor or ARBs. Other treatment modalities include surgery (endoscopic injection of ...
Children who hold their bladder or who are constipated have a greater number of infections than children who void on a regular schedule. When medical management fails to prevent recurrent urinary tract infections, or if the kidneys show progressive renal scarring then surgical interventions may be necessary.
In addition children under the age of 5 generally have a poorer prognosis than prepubescents, as do adults older than 30 years of age as they have a greater risk of kidney failure. [61] Other causes such as focal segmental glomerulosclerosis frequently lead to end stage kidney disease.
Chronic pyelonephritis implies recurrent kidney infections and can result in scarring of the renal parenchyma and impaired function, especially in the setting of obstruction. A perinephric abscess (infection around the kidney) and/or pyonephrosis may develop in severe cases of pyelonephritis.
Juvenile nephronophthisis causes fibrosis and scarring of the kidneys, which accounts for the symptoms observed. The kidneys also often have corticomedullary cysts. [1] Inability to conserve sodium because of defect of tubules leading to polyuria and polydipsia. Anemia is attributed to a deficiency of erythropoietin production by failing kidneys.
Nephronophthisis is a genetic disorder of the kidneys which affects children. [3] It is classified as a medullary cystic kidney disease.The disorder is inherited in an autosomal recessive fashion and, although rare, is the most common genetic cause of childhood kidney failure.