drsidharthkumarsethi
Child Kidney Specialist in India
Dr. Sidharth is one of the best Pediatric Nephrology, Pediatric Kidney Transplant, Nephrotic syndrome and Child Kidney Specialist in Gurgaon, Delhi, India. With his years of experience he gives expert advice for Pediatric Surgery treatment.
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Nephrotic syndrome Specialist in Delhi - Dr. Sidharth Kumar sethi
Nephrotic Syndrome
Most people have two kidneys, one on either side of the body just beneath the ribcage. Healthy kidneys filter the blood and allow small particles of waste products and water to be excreted as urine. Kidneys also play important role in the control of blood pressure, maintenance of bone health and formation of red blood cells.
What is nephrotic syndrome?
Nephrotic syndrome occurs when the kidneys leak large amounts of protein (especially albumin) into the urine. It is these proteins which is mainly responsible for holding water in the blood vessels, and when they are lost in urine, their level decreases in the blood which causes the water to come out of the blood vessels and cause swelling (edema).
What causes Nephrotic Syndrome?
In most cases, the exact cause of nephrotic syndrome is not known. There is no relationship with diet or socioeconomic status of the family. It is non-infectious and does not transfer to other family members
.
What are the symptoms?
The most common symptom is swelling (edema). It first appears on the face, especially around the eyes which is most prominent in the morning when the child gets up and decreases by the evening.
Other symptoms include: Frothy urine, weakness and tiredness, passing less urine than usual, recurrent infections, diarrhoea.
What is the treatment?
Prednisolone (steroid) is the drug of choice when the child is first diagnosed. Most children respond to this drug with disappearance of the protein in the urine and loss of swelling within 1-2 weeks (we call this REMISSION). Other drugs like diuretics, ACE inhibitors, etc may be required for symptomatic treatment.
Those who do not respond to steroids are given second line drugs like Cyclophosphamide, MMF, Levamisole and other immunomodulators as decided by your doctor according to the individual patient profile.
Duration of treatment: First episode is treated for 3 months and subsequent episodes are treated as decided by your physician.
What are the side effects of the treatment?
Common Side Effects of Steroids are:
Decreased resistance to infections such as cough and cold
Increase in appetite
Flushed, swollen cheeks and stretch marks on the skin
Rise in blood pressure
Behavioral problems e.g temper tantrums, or mood changes.
However most of the side effects are reversible and wean off once the steroid is stopped.
Long term supervision and course of nephrotic syndrome
In most cases the child with nephrotic syndrome becomes completely well with prednisolone treatment, and there are very few who require second line treatment which includes immunomodulators and other drugs.
The child may remain well for several months or longer. During this period, the child should be regarded as being normal, and should not be made to feel different from other children.
In majority of cases, however, nephrotic syndrome recurs. The recurrence is indicated by appearance of swelling around the eyes, which, if untreated, gradually increases to involve the face, feet, legs and abdomen, and in such conditions, doctor should be consulted immediately. Relapses are common in early childhood but decrease with age.
More than 90% of children with nephrotic syndrome go into adulthood with their kidneys functioning normally.
What are parents expected to do at home?
Swelling around the eyes
Decreased urine output
Urine protein 1+ or more for persistent 2-3 days
Any sign of infection like cough, cold, coryza.
What immunizations are necessary?
Children who are on steroid medications and other immunosuprressives can become very unwell if exposed to CHICKENPOX or MEASLES, therefore they should be immunized for the same and also receive pneumococcal vaccine.
Tags - Nephrotic syndrome Specialist in India, Nephrotic syndrome Specialist in Delhi, Pediatric Nephrology India
For more information link - www.pediatricnephrologyindia.com
#Nephrotic syndrome Specialist in Delhi#Nephrotic syndrome Specialist in India#Pediatric Nephrology India#Dr. Sidharth Kumar Sethi#Pediatricnephrologyindia
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Recent literature has endorsed favorable outcomes following ABOi kidney transplantation in pediatric population. Nevertheless, reluctance to pursue an ABOi still remains pervasive. This could be ascribed to various legitimate reasons, namely less ext
#Pediatric Kidney Transplant Specialist in Delhi#Pediatric Nephrology India#Best Pediatric Nephrologist in India#Dr. Sidharth Kumar sethi#Pediatricnephrologyindia
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Pediatric Kidney Transplant Specialist in Delhi - Dr. Sidharth Kumar Sethi
ABO Incompatible Kidney Transplant In Children
Recent literature has endorsed favorable outcomes following ABOi kidney transplantation in pediatric population. Nevertheless, reluctance to pursue an ABOi still remains pervasive. This could be ascribed to various legitimate reasons, namely less extensive pediatric ABOi data, technical difficulties encountered during PP, cost restraints, and concerns regarding higher rates of antibody-mediated rejection, infectious complications, and post-transplant lymphoproliferative disorder as compared to adults. However, given the similar excellent outcomes of both ABOi and ABOc kidney transplantation, clinicians should consider this option sooner if a compatible donor or swap is not available. Here, we describe the outcomes of three pediatric ABOi performed at our institute in India (from 2014 till now), wherein distinct apheresis modalities had been employed in each desensitization protocol, and our techniques evolved with advancing science in apheresis. This case series includes India’s first published pediatric ABO-incompatible transplant (Case 2) and the youngest child to undergo ABO-incompatible renal transplant in SAARC nations (Case 3).
Tags - Pediatric Kidney Transplant Specialist in Delhi, Pediatric Nephrology India, Best Pediatric Nephrologist in India
For more information link - www.pediatricnephrologyindia.com
#Pediatric Kidney Transplant Specialist in Delhi#Pediatric Nephrology India#Best Pediatric Nephrologist in India#Dr. Sidharth Kumar Serthi#Pediatricnephrologyindia
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Dr. Sidharth is one of the best Pediatric Nephrology, Pediatric Kidney Transplant, Nephrotic syndrome and Child Kidney Specialist in Gurgaon, Delhi, India. With his years of experience he gives expert advice for Pediatric Surgery treatment.
#Child Kidney Specialist in India#Child Kidney Doctor in India#Best Pediatric Nephrologist in India#Dr. sidharth Kumar Sethi#Pediatricnephrologyindia
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Child Kidney Specialist in India, Child Kidney Doctor in India - Dr. Sidharth Kumar Sethi
Dr. Sidharth Kumar sethi - Child Kidney Specialist in India
He was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and Expert committee involved in the formulation of guidelines of Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of Editorial Board of “World Journal of Nephrology” and “eAJKD- Web version of American Journal of Kidney Diseases”. He is a reviewer for Pediatric Nephrology related content for various Pediatric and Nephrology journals
Tags - Pediatric Nephrology India, Child Kidney Specialist in India, Child Kidney Doctor in India
For more infomation link - www.pediatricnephrologyindia.com
#Pediatric Nephrology India#Child Kidney Specialist in India#Child Kidney Doctor in India#Dr. sidharth Kumar Sethi
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Overview of urinary tract infections (UTIs)-causes, signs and symptoms, diagnosis, treatment and potential future complications
#Best Pediatric Nephrologist in India#Pediatric Nephrology India#Pediatricnephrologyindia#Dr. Sidharth Kumar Sethi
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Understanding Urinary Tract Infections From Dr. Sidharth Kumar Sethi Pediatric Kidney Transplant Specialist in Delhi, India
Understanding Urinary Tract Infections
This topic is intended to give the parents and caregivers a comprehensive overview of urinary tract infections (UTIs)-causes, signs and symptoms, diagnosis, treatment and potential future complications, so that they can lend a helping hand in building a better kidney health for their children.
What does the urinary tract consist of?
KIDNEYS -These are two bean shaped organs situated on either side of our back. They filter the blood off the wastes and produce urine.
URETERS -These are two tubes through which urine from the kidney travels down.
URINARY BLADDER –It is a bag which stores urine coming in from the ureters.
URETHRA –It is a thin tube from which urine comes out of the body whenever we urinate.
What’s a uti?
A UTI occurs when bacteria (germs) invade the urinary tract through infected urine. Overall, UTI is commoner in girls than boys, except in first year of life as structural problems of urinary tract at birth are seen more in boys putting them at a higher risk of UTIs.
A lower UTI involves infection of the bladder (cystitis) or urethra.
An upper UTI involves the kidney (pyelonephritis) and is more serious.
How would i come to know that my child has a uti?
UTI is common in babies and young kids. It is hard to pick up a UTI in them as they might have just a few non-specific signs like-
Fever(>38°C)
Vomiting
Lethargy(tiredness)
Irritability
Poor feeding
Crying on passage of urine
Frequent bed wetting
Increased thirst, soft sunken spot on head (due to dehydration-lack of enough water in the body)
Older kids may also complain -
Burning/stinging sensation while peeing (dysuria)
Increased frequency of urination
Cloudy urine
Desire to hold on urine to avoid pain
When to suspect a kidney infection?
High fever spikes despite taking paracetamol
Back pain
Red/dark brown urine (hematuria)
Why does my child have recurrent uti?
Most kids adequately treated for UTI do not have a repeated infection. But some kids go on having recurrent UTIs even after complete treatment. It is important to pay attention to it as they might have a structural urinary tract problem like vesicoureteric reflux (VUR).
VUR is due to improper insertion of the ureters into the bladder. This causes backflow of urine from the bladder up towards ureters and sometimes into the kidneys whenever the child pees. It can result in serious kidney infection and irreversible kidney damage (by scarring), if not detected and treated early.
Some red flags to keep in mind-
Any congenital urinary tract problem
Family history of VUR or kidney disease
History of neurogenic bladder (problems in fully emptying the bladder, poor urine flow) and/or chronic constipation
Hypertension (high blood pressure), poor growth
What can i do to save my kid from a uti?
Encourage your child to pee every 3-4 hrs and, prior to bathing and sleeping.
Change your baby’s nappies frequently.
Teach your kid not to hold on his/her urine.
Try to avoid constipation.
Make him/her drink plenty of water and other fluids.
Girls should wipe off their bottoms from front to back after a bowel movement to avoid introduction of any germs from bowel into urethra.
Boys should gently clean the area below their penile foreskin as far as possible without forcing it back. Some boys with recurrent UTIs may need to have their foreskin incised (circumcision).
If your kid has neurogenic bladder, double voiding (going to toilet twice- urinate once standing and then sitting) can help.
Seeking medical advice
If you suspect that your child has a UTI, consult your pediatric nephrologist immediately. The doctor would run the following tests on your kid’s urine sample to detect a UTI.
Urine dipstick- It is a paper strip containing a reagent which changes color when it comes in contact with infected urine.
Urine microscopy-It looks for the germs under a microscope.
Urine culture-It grows and identifies the bacteria causing UTI on a separate medium in a lab and also tells which antibiotic will kill those bacteria.
Some special tests would be needed if your child has recurrent UTIs. These include-
Ultrasound scan- A safe hand-held device emits sound waves and brings up pictures of the urinary tract on the screen.
MCU/MCUG/VCUG-This test detects VUR. A dye is injected into the bladder via the urethra and serial X-rays are taken when your child urinates.
DMSA scan- This test looks for any structural damage (scars) in the kidneys. A chemical is injected in the blood and images of urinary tract are taken by a camera.
Blood urea, Serum creatinine-It is a simple blood test which determines the kidney function by various parameters.
Would my child get well?
Most UTIs get treated with a full course of antibiotics as prescribed by your doctor with no long-term sequelae. Paracetamol can be given to bring down the fever and pain. Avoid Ibuprofen (Brufen) if the child has a kidney problem or asthma. The child would start feeling better in a day or two but you should not stop the treatment at this stage. This is to ensure that all germs get killed to avoid any relapse. Your child can get back to school once he feels better as UTIs are not infectious (others won’t catch it).
Tags - Pediatric Nephrology India, Best Pediatric Nephrologist in India
For more information link- www.pediatricnephrologyindia.com
#Pediatric Nephrology India#Best Pediatric Nephrologist in India#Pediatricnephrologyindia#Dr. sidharth Kumar Sethi
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Healthy kidneys for Healthy kids call Dr. Sidharth he is Child Kidney Specialist and Child Kidney Doctor in Gurgaon, Delhi, India.
#Child Kidney Specialist in India#Child Kidney Doctor in Delhi#Child Kidney Specialist in Delhi#Dr. Sidharth Kumar sethi#Pediatricnephrologyindia
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Nephrotic syndrome Specialist Delhi - Dr. Sidharth Kumar Sethi
Nephrotic Syndrome
Most people have two kidneys, one on either side of the body just beneath the ribcage. Healthy kidneys filter the blood and allow small particles of waste products and water to be excreted as urine. Kidneys also play important role in the control of blood pressure, maintenance of bone health and formation of red blood cells.
What is nephrotic syndrome?
Nephrotic syndrome occurs when the kidneys leak large amounts of protein (especially albumin) into the urine. It is these proteins which is mainly responsible for holding water in the blood vessels, and when they are lost in urine, their level decreases in the blood which causes the water to come out of the blood vessels and cause swelling (edema).
What causes Nephrotic Syndrome?
In most cases, the exact cause of nephrotic syndrome is not known. There is no relationship with diet or socioeconomic status of the family. It is non-infectious and does not transfer to other family members
.
What are the symptoms?
The most common symptom is swelling (edema). It first appears on the face, especially around the eyes which is most prominent in the morning when the child gets up and decreases by the evening.
Other symptoms include: Frothy urine, weakness and tiredness, passing less urine than usual, recurrent infections, diarrhoea.
What is the treatment?
Prednisolone (steroid) is the drug of choice when the child is first diagnosed. Most children respond to this drug with disappearance of the protein in the urine and loss of swelling within 1-2 weeks (we call this REMISSION). Other drugs like diuretics, ACE inhibitors, etc may be required for symptomatic treatment.
Those who do not respond to steroids are given second line drugs like Cyclophosphamide, MMF, Levamisole and other immunomodulators as decided by your doctor according to the individual patient profile.
Duration of treatment: First episode is treated for 3 months and subsequent episodes are treated as decided by your physician.
What are the side effects of the treatment?
Common Side Effects of Steroids are:
Decreased resistance to infections such as cough and cold
Increase in appetite
Flushed, swollen cheeks and stretch marks on the skin
Rise in blood pressure
Behavioral problems e.g temper tantrums, or mood changes.
However most of the side effects are reversible and wean off once the steroid is stopped.
Long term supervision and course of nephrotic syndrome
In most cases the child with nephrotic syndrome becomes completely well with prednisolone treatment, and there are very few who require second line treatment which includes immunomodulators and other drugs.
The child may remain well for several months or longer. During this period, the child should be regarded as being normal, and should not be made to feel different from other children.
In majority of cases, however, nephrotic syndrome recurs. The recurrence is indicated by appearance of swelling around the eyes, which, if untreated, gradually increases to involve the face, feet, legs and abdomen, and in such conditions, doctor should be consulted immediately. Relapses are common in early childhood but decrease with age.
More than 90% of children with nephrotic syndrome go into adulthood with their kidneys functioning normally.
What are parents expected to do at home?
Starting and stopping of medicines should be strictly done as advised by the doctor.
Daily urine protein monitoring by urine dipsticks till negative for three days then atleast thrice a week during remission.
Keep a diary of all urine results so that your doctor can review your child’s progress in clinic. The dose of Prednisolone and any other medications and other comments should also be recorded.
In remission phase immediately report to the doctor under following conditions:
Swelling around the eyes
Decreased urine output
Urine protein 1+ or more for persistent 2-3 days
Any sign of infection like cough, cold, coryza.
Here is an example of how to record your child’s progress:
Date Urine protein Prednisolone dose (mg) Comments/remarks
01/08/15 3+ 40mg Swelling+/urine output decreased
02/08/15 2+ 40mg Swelling+; cough+
03/08/15 2+ 40mg Swelling+; cough+
04/08/15 1+ 40mg Swelling+
Dietary advice for your child:
The child should be given a diet with enough proteins. High protein food items include milk and milk products, dal, chana, soyabean, eggs, meat and fish.
If the child is edematous, the doctor might advise salt restriction. Once the swelling disappears, the child can have his usual diet. It must be understood that salt has no role in the causation of nephrotic syndrome. No benefit can be expected by prolonged restriction of salt unless advised by the doctor for some other reason (e.g., if the blood pressure is high).
When is kidney biopsy required?
Very few children require kidney biopsy. Certain conditions in which children do not respond to daily treatment or have persistent gross hematuria, persistent hypertension, low complement level (C3 / C4) require kidney biopsy.
What immunizations are necessary?
Children who are on steroid medications and other immunosuprressives can become very unwell if exposed to CHICKENPOX or MEASLES, therefore they should be immunized for the same and also receive pneumococcal vaccine.
Tags - Nephrotic syndrome Specialist in India, Nephrotic syndrome Specialist in Delhi, Pediatric Nephrology India
For more information link - www.pediatricnephrologyindia.com
#Nephrotic syndrome Specialist in Delhi#Nephrotic syndrome Specialist in India#Pediatric Nephrology India#Pediatricnephrologyindia#Dr. sidharth Kumar sethi
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'Virtual PEDIATRIC Kidney Transplant Update 2021' was a very successful meeting with more than 800 attendees from across the world joining together to learn! Thanks to all of you for making it a grand success!
#pediatric nephrology india#Pediatric Kidney Transplant Specialist in Delhi#Dr. Sidharth Kumar Sethi#Pediatricnephrologyindia
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Pediatric Kidney Transplant Specialist in Delhi - Dr. Sidharth Kumar Sethi
Pediatric Kidney Transplant
‘Virtual PEDIATRIC Kidney Transplant Update 2021’ was a very successful meeting with more than 800 attendees from across the world joining together to learn! Thanks to all of you for making it a grand success!
Dr. Sidharth Kumar Sethi
Dr. Sidharth Kumar SethiHe was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and Expert committee involved in the formulation of guidelines of Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of Editorial Board of “World Journal of Nephrology” and “eAJKD- Web version of American Journal of Kidney Diseases”. He is a reviewer for Pediatric Nephrology related content for various Pediatric and Nephrology journals
Tags - Pediatric Nephrology India, Pediatric Kidney Transplant Specialist in Delhi
For more information link- www.pediatricnephrologyindia.com
#Pediatric Kidney Transplant Specialist in Delhi#Pediatric Nephrology India#Dr. Sidharth Kumar sethi#Pediatricnephrologyindia
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Dr. Sidharth Best Pediatric Nephrologist in Gurgaon provide Nephrotic syndrome treatment in Gurgoan, Delhi, India.
#Nephrotic syndrome Specialist in Delhi#Nephrotic syndrome Specialist in India#Pediatric Nephrology India#Dr. Sidharth Kumar Sethi#Pediatricnephrologyindia
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Critical Care Pediatric Nephrology & Pediatric Dialysis - Pediatricnephrologyindia
Pediatric Dialysis Specialist in Delhi - Dr. Sidharth Kumar Sethi
Happy to see the success of our ‘Handbook of Protocols of Critical Care Pediatric Nephrology & Pediatric Dialysis’ with Springers Publishers!
It’s been two years and we get positive reviews each day!
Thanks to the patients who are also teachers…
Dr. Sidharth Kumar Sethi
Dr. Sidharth Kumar SethiHe was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and Expert committee involved in the formulation of guidelines of Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of Editorial Board of “World Journal of Nephrology” and “eAJKD- Web version of American Journal of Kidney Diseases”. He is a reviewer for Pediatric Nephrology related content for various Pediatric and Nephrology journals
Tags - Pediatric Dialysis Specialist in delhi, Pediatric Dialysis Specialist in India, Pediatric Nephrology India
For more information link- www.pediatricnephrologyindia.com
#Pediatric Dialysis Specialist in delhi#Pediatric Dialysis Specialist in India#Pediatric Nephrology India#Dr. Sidharth Kumar Sethi#Pediatricnephrologyindia
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Child Kidney Specialist in Delhi - Dr. Sidharth Kumar sethi
Healthy Kidneys For Healthy Kids
Better kidney health for kids: What you should know!
Did you know that kidney diseases can start young? Literally. Unlike in the case of grown-ups, children can develop kidney diseases due to congenital defect, prematurity, or past hospitalization. "Also, children with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Needless to say that the sooner the issue is diagnosed, better can be the results," adds Dr Sidharth Kumar Sethi, Consultant, Pediatric Nephrology, Medanta, The Medicity, Gurgaon.
Early signs of kidney disease in kids
Early diagnose of kidney problem can help treat the ailment in time. Here are some signs that you should watch out for:
- Swelling around the eyes-face -feet- abdomen- whole body - Bed wetting (5 years or older) can be since birth or if the problem recurs after the child had stopped bed wetting for some time -Frequent urination - Crying during urination (in infants) - Painful urination (in older kids) - Unpleasant-smelling urine -Unexplained low-grade fever or recurrent fever episodes - Urine that is cloudy, bloody or dark brown - Persistent abdominal pain - Childhood renal stones - Frequent severe headaches - High blood pressure - Producing less urine -Producing more than 2 litre urine/ day -Poor appetite (in older children) - Poor eating habits, vomiting (in newborns & infants) - Slow growth or weight gain -Weak urinary stream, dribbling of urine stream - Weakness, excessive tiredness or loss of energy - Pale skin appearance
Protection plan
Have lots of water: To keep kidneys healthy, kids should stay hydrated- mostly by drinking water. Their pee should be pale in color, and they should drink more than usual when exercising especially under a hot sun. Kids should avoid nutrient-spiked drinks. Enough water is still the best and safest bet to meet their fluid needs.
Avoid sports drinks and processed: Today's diets are so extreme and unhealthy. Vitamin waters, sports or energy drinks, processed 'super-foods' are not nutritious and add to the risk of obesity in children.
Avoid too much protein: Protein intake should be in adequate amount. It is advisable to not make your kids indulge in too much protein.
Excess salt is bad: Too much sodium (in junk food, burgers, chips and street food) can contribute to high blood pressure. Eating more whole foods, choosing fewer processed foods- emphasizing those with made without added salt or sauce can help lower sodium intake. Cooking more at home can also help families slash sodium. Cut back on table salt and salty snacks.
Regular exercise: Increasing physical activity not only helps to reduce blood pressure, but it can help a child who is overweight reach and maintain a healthy weight. Sports and exercise programs at school may be good ways to increase the child's activity level.
Who should be screened?
Following children should be screened by a specialist for blood and urine test; growth and blood pressure:
Family history of kidney disease
Children born early or small-for-date
Obese children; or those not growing well
Abnormal antenatal ultrasound
History of urine infection
Abnormal urine examination
It is also extremely important for the health community to encourage pregnant females to undergo antenatal ultasonography. With the growing cases of kidney issues in children, it is crucial that we encourage and facilitate education, early detection and a healthy life style in children, starting at birth and continuing through to old age, to combat the increase of preventable kidney damage and to treat children early.
Tags - Child Kidney Specialist in Delhi, Child Kidney Specialist in Gurgaon, Pediatric Nephrology India
For more information link - www.pediatricnephrologyindia.com
#Pediatric Nephrology India#Child Kidney Doctor in India#Child Kidney Specialist in Delhi#Dr. Sidharth Kumar sethi
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Dr. Sidharth at Medanta, The Medicity is the leading Pediatric Nephrologist providing diagnostic and treatment services for children with conditions of the kidney especially Nephrotic syndrome, Chronic Kidney disease, Pediatric Dialysism Renal Transplantation etc.
#Best Pediatric Nephrologist in Delhi#Nephrotic syndrome Specialist in Delhi#Pediatric Dialysis Specialist in delhi#Pediatric Nephrology India
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Dr. Sidharth is one of the best Pediatric Nephrology, Pediatric Kidney Transplant, Nephrotic syndrome and Child Kidney Specialist in Gurgaon, Delhi, India. With his years of experience he gives expert advice for Pediatric Surgery treatment.
#Best Pediatric Nephrologist in India#Child Kidney Specialist in Delhi#Nephrotic syndrome Specialist in Delhi#Dr. Sidharth Kumar Sethi
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Nephrotic syndrome Specialist in India - Dr. Sidharth Kumar Sethi
Nephrotic Syndrome
Most people have two kidneys, one on either side of the body just beneath the ribcage. Healthy kidneys filter the blood and allow small particles of waste products and water to be excreted as urine. Kidneys also play important role in the control of blood pressure, maintenance of bone health and formation of red blood cells.
What is nephrotic syndrome?
Nephrotic syndrome occurs when the kidneys leak large amounts of protein (especially albumin) into the urine. It is these proteins which is mainly responsible for holding water in the blood vessels, and when they are lost in urine, their level decreases in the blood which causes the water to come out of the blood vessels and cause swelling (edema).
What causes Nephrotic Syndrome?
In most cases, the exact cause of nephrotic syndrome is not known. There is no relationship with diet or socioeconomic status of the family. It is non-infectious and does not transfer to other family members
.
What are the symptoms?
The most common symptom is swelling (edema). It first appears on the face, especially around the eyes which is most prominent in the morning when the child gets up and decreases by the evening.
Other symptoms include: Frothy urine, weakness and tiredness, passing less urine than usual, recurrent infections, diarrhoea.
What is the treatment?
Prednisolone (steroid) is the drug of choice when the child is first diagnosed. Most children respond to this drug with disappearance of the protein in the urine and loss of swelling within 1-2 weeks (we call this REMISSION). Other drugs like diuretics, ACE inhibitors, etc may be required for symptomatic treatment.
Those who do not respond to steroids are given second line drugs like Cyclophosphamide, MMF, Levamisole and other immunomodulators as decided by your doctor according to the individual patient profile.
Duration of treatment: First episode is treated for 3 months and subsequent episodes are treated as decided by your physician.
What are the side effects of the treatment?
Common Side Effects of Steroids are:
Decreased resistance to infections such as cough and cold
Increase in appetite
Flushed, swollen cheeks and stretch marks on the skin
Rise in blood pressure
Behavioral problems e.g temper tantrums, or mood changes.
However most of the side effects are reversible and wean off once the steroid is stopped.
Long term supervision and course of nephrotic syndrome
In most cases the child with nephrotic syndrome becomes completely well with prednisolone treatment, and there are very few who require second line treatment which includes immunomodulators and other drugs.
The child may remain well for several months or longer. During this period, the child should be regarded as being normal, and should not be made to feel different from other children.
In majority of cases, however, nephrotic syndrome recurs. The recurrence is indicated by appearance of swelling around the eyes, which, if untreated, gradually increases to involve the face, feet, legs and abdomen, and in such conditions, doctor should be consulted immediately. Relapses are common in early childhood but decrease with age.
More than 90% of children with nephrotic syndrome go into adulthood with their kidneys functioning normally.
What are parents expected to do at home?
Starting and stopping of medicines should be strictly done as advised by the doctor.
Daily urine protein monitoring by urine dipsticks till negative for three days then atleast thrice a week during remission.
Keep a diary of all urine results so that your doctor can review your child’s progress in clinic. The dose of Prednisolone and any other medications and other comments should also be recorded.
In remission phase immediately report to the doctor under following conditions:
Swelling around the eyes
Decreased urine output
Urine protein 1+ or more for persistent 2-3 days
Any sign of infection like cough, cold, coryza.
Dietary advice for your child:
The child should be given a diet with enough proteins. High protein food items include milk and milk products, dal, chana, soyabean, eggs, meat and fish.
If the child is edematous, the doctor might advise salt restriction. Once the swelling disappears, the child can have his usual diet. It must be understood that salt has no role in the causation of nephrotic syndrome. No benefit can be expected by prolonged restriction of salt unless advised by the doctor for some other reason (e.g., if the blood pressure is high).
When is kidney biopsy required?
Very few children require kidney biopsy. Certain conditions in which children do not respond to daily treatment or have persistent gross hematuria, persistent hypertension, low complement level (C3 / C4) require kidney biopsy.
What immunizations are necessary?
Children who are on steroid medications and other immunosuprressives can become very unwell if exposed to CHICKENPOX or MEASLES, therefore they should be immunized for the same and also receive pneumococcal vaccine.
Tags - Nephrotic syndrome Specialist in India, Nephrotic syndrome Specialist in Delhi, Pediatric Nephrology India
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