Pediatric nephrology in Antalya, Alanya, Kemer, Istanbul.
Pediatric nephrology, which is one of the subsections of the Department of Pediatrics, is a medical science that deals with the diagnosis and treatment of diseases of the kidneys and urinary system in children aged 0 to 18 years. The kidneys, which provide water, acid-base balance and electrolyte balance in the body, are organs that filter blood, ensure the excretion of harmful toxins in the form of urine and provide information about how much blood needs to be made into the bone marrow. The urinary system consists of the ureter, the bladder, and the urethra, known as the urinary tract, to which the kidneys are attached. Congenital or acquired diseases of the urinary system are diagnosed and treated by pediatric nephrologists who have received a total of 13 years of medical education. Specialist doctors prevent the occurrence of irreversible damage, such as kidney failure, by taking protective measures to prevent recurrence of the disease. Depending on the condition of the disease, patients are treated on an outpatient basis in a pediatric nephrological outpatient clinic or inpatient in a pediatric nephrological clinic.
What diseases does pediatric nephrology study?
Pediatric nephrologists are engaged in the diagnosis and treatment of the following groups of diseases, which are among the diseases of the urinary system:
Diseases of the renal parenchyma
Cystic kidney disease
Glomerular diseases
Tubulointerstitial diseases
Kidney damage due to systemic diseases
Blood and urine tests are carried out in biochemical and microbiological laboratories to diagnose all these groups of nephrological diseases. If necessary, radiology conducts examinations that include modern imaging methods, such as ultrasound (Dopplerography), cystourethrography of urination, intravenous pyelography, computed tomography, magnetic resonance imaging (MRI). In addition, kidney scintigraphic studies, called DMSA, DTPA, MAG-3, are also conducted by the Department of Nuclear Medicine. Below are some diseases that are common among these groups of diseases.
What is urinary incontinence? (Day/Night)
Urinary incontinence in children is most often caused by a functional disorder of the bladder, known as the bladder. In rare cases, it may have a neurogenic and anatomical origin. Frequent urination and urinary incontinence in the form of drops may occur due to low bladder capacity. In a case called a lazy bladder, an overly enlarged bladder becomes insensitive to filling. Some patients may also experience fecal incontinence accompanying urinary incontinence. This condition is caused by dysfunction of the bladder and intestines. Sometimes, the diagnosis of urinary incontinence requires anamnesis, laboratory and X-ray examinations, which can manifest themselves during physical exertion, such as running or laughing. Treatment is carried out in accordance with the diagnosis, medical or surgical operations.
What is a urinary tract infection?
Urinary tract infection is the second most common type of infection after upper respiratory tract infections. Urinary tract infection, which occurs in both infants and children, is usually manifested by symptoms such as frequent urination, burning during urination, fever, abdominal pain, nausea and vomiting. Recurrent infection can pose a danger to the kidneys, and concomitant diseases such as obstruction, the presence of stones and urine leakage should also be investigated. If there is no other underlying cause, appropriate antibiotic treatment begins when the doctor deems it necessary.
What is urination of stones and sand?
Unlike the symptoms observed in adults, symptoms of problems with stones are observed in children; yellowing of the skin, abdominal pain, loss of appetite, blood in the urine, sometimes nausea and vomiting. The diagnosis is clarified with the help of laboratory analysis and X-ray imaging. Depending on the size of the stone, the doctor may recommend waiting, but if the symptoms are serious enough to reduce the patient's quality of life, the stone is broken by endoscopic surgery.
What is hypertension?
Unlike adults, blood pressure in children varies depending on age, height and gender. Hypertension in children is a condition in which it is higher than the value that should be when taking into account these differences. Arterial hypertension is about 3 times more common in obese children. Its causes are considered in two different groups: primary and secondary arterial hypertension. While primary hypertension is hypertension of unclear etiology, secondary hypertension develops due to hormonal, renal, vascular and neurological diseases and the use of medications. After the cause of hypertension is fully determined, appropriate treatment is recommended. In general, diet and medication are recommended for the treatment of hypertension.
What is hematuria?
The appearance of blood in the urine of children is called hematuria. The main causes are urinary tract infections, structural disorders and injuries of the urinary system. After a detailed medical history and physical examination, a pediatric nephrologist may prescribe additional laboratory and X-ray examinations. If urea and creatinine levels are normal as a result of blood tests, the patient is regularly monitored. However, if the condition persists, if there is a deviation in laboratory tests, inflammation in the renal tissue, that is, nephritis, can be suspected. In this case, the doctor prescribes a biopsy and finds out the condition that caused hematuria. In some cases, the presence of kidney stones can also cause hematuria.
What is nephrotic syndrome?
It occurs when the proteins necessary for the body are excreted together with urine during the filtration process performed by the kidneys due to their duties, in other words, the kidneys cannot perform their function. It is manifested by symptoms such as swelling of the legs and eyelids, weight gain due to water retention, hypertension. There can be many causes of nephrotic syndrome caused by inflammation in the renal tissue. To diagnose it, blood and urine tests are performed, as well as a kidney biopsy. After the root causes are identified, appropriate treatment is prescribed.
What is proteinuria?
The condition observed when protein excretion in urine analysis is higher than normal, that is, more than 4 mg per square meter for one hour, is called proteinuria. This is an important clinical indicator of kidney disease. If left untreated, it can lead to kidney failure. It is most often treated with diet and medication. However, in some cases, a kidney biopsy is required.
What is vesicoureteral reflux?
Vesicoureteral reflux, known as reverse reflux or renal reflux, is a very common disease in children. The recurrence rate of the disease in children in the community is 35%. Vesicoureteral reflux, which is a condition in which urine exits back into the kidney due to a structural defect in the urinary canal at the point where it opens to the bladder, is treated with medication or endoscopic surgery.
What is ureteral stenosis?
Ureteral stenosis, which is defined as urinary tract stenosis, makes it difficult to remove urine from the kidneys, increasing the risk of frequent urinary tract infections. It is characterized by intense abdominal pain, darkening of urine and the appearance of blood. In older age groups, it is manifested by complaints of nausea, vomiting and pain in the kidney area. Ureteral stenosis can also be detected in children in the womb during routine examinations. This condition is observed until the baby turns 18 months old, taking into account the possibility of spontaneous recovery. The purpose of treatment is to prevent kidney damage. Endoscopic surgery provides drainage of the ureter from the pelvis.
What kidney problems occur during pregnancy?
Fetal kidney functions in the womb are covered by the mother. On the other hand, the urine produced by the baby forms a liquid called amniotic fluid, in which the baby floats in the womb. This fluid fills the lungs and digestive system of the baby, playing a key role in the development of these areas. If the baby's kidneys are not working, the amniotic fluid does not fill the lungs, and the baby dies shortly after birth. In some cases, diseases such as urinary tract stenosis, vesicoureteral reflux and kidney cyst may occur in the womb. These diseases, which can lead to kidney damage and kidney failure, should be treated without worsening kidney function.
What is hereditary kidney disease?
Autosomal dominant polycystic kidney disease is the most common hereditary kidney disease. Diseases such as nephronophysis, diabetic nephropathy and Alport syndrome can be observed in children from sick families. In some cases, for example, in a related marriage, hereditary kidney diseases are also observed in their children, even if the parents themselves are not sick. In children with a genetic transition, the following diseases can be observed in this way, which can lead to kidney failure:
Polycystic kidney disease
Medullary cystic kidney disease
Nephrotic syndrome
Cystinosis
Oxalosis