Specialties

Pediatric nephrology

Nephrology or renal medicine is mainly deals with diseases affecting or related to the kidneys.

A pediatric nephrologist specialises in kidney diseases between the ages of 0 and 18, which may differ in type and incidence from those known in adult nephrology.  In contrast to adult nephrology, to a certain extent, it also cares for patients diagnosed with developmental disorders of the kidneys and urinary tract, in close collaboration with surgical specialists, pediatric surgeons and urologists.

You may consult a nephrologist with the following test based deviations and complaints:

  • abnormal kidney function (increased creatinine, urea nitrogen levels)
  • abnormal urinalysis results (proteinuria, purulent urine, hematuria)
  • apparent urine abnormalities (bloody, dark urine)
  • if the child drinks or urinates a lot (polydipsia, polyuria)
  • nighttime bedwetting (girls over 5 years, boys over 6 years or before starting school)
  • frequent urge to urinate during the day, leaking urine, involuntary urine loss
  • developmental disorders of the kidneys or urinary tract detected by ultrasound (certain abnormalities require the involvement of a pediatric surgeon/urologist)
  • kidney stones, which may be associated with lower back pain
  • hypertension in childhood

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More common diseases are:

  • urinary tract infections (inflammation of the renal pelvis, cystitis)
  • bed wetting (enuresis nocturna, over 5 years in girls and 6 years in boys)
  • daytime urinary disturbance, difficulty in urinary continence, frequent, painful urination
  • anatomical abnormalities (e.g. unilateral renal pelvis dilatation, urethral dilatation)
  • high blood pressure (hypertension)
  • kidney stones

Rarer diseases are:

  • kidney diseases of immunological origin (nephrotic syndrome, IgA nephropathy)
  • cystic, hereditary kidney diseases
  • chronic renal failure

Overall, nephrotic syndrome is a rare disease, but one that is more commonly treated in pediatric nephrology; this is an immunological kidney disease with recurrent increased proteinuria and water detention (oedema).

In addition to the above, as nephrologists we also provide care for

  • patients suffering from autoimmune diseases affecting the kidneys
  • tubular diseases (rare diseases of the renal tubule, metabolic disorders)
  • acute and chronic kidney disease
  • chronic renal failure (patients on renal replacement therapy)
  • and transplant patients as well

(The treatment of some of these latter diseases is mostly linked to renal medicine centres.)

In pediatrics, aspects of genetics cannot be neglected, as many kidney diseases can be caused by genetic disorders (e.g. cystic diseases: polycystic kidney disease, multicystic and solitary renal cysts). In case of suspicion, we seek the help of a clinical geneticist.

The procedure of examinations performed in the practice:

The pediatric nephrologist first

  • listens to the complaints
  • checks the medical history
  • reviews the available previous findings
  • asks about family history (anamnesis)
  • if necessary, requests further laboratory tests (blood or urine tests)
  • if needed, orders further diagnostic procedures and imaging tests

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