儿科学英文课件：Renal diseases in children.pptx

;Newborn: 1-3ml/kg/hr，48hr after birth oliguria 1ml/kg/hr；anuria? 0.5ml/kg/hr Oliguria School age: 400ml/d Preschool age: 300ml/d Infant: 200ml/d Anuria: 50ml/d ;Urine test;Ccr(ml/min)=;Estimated GFR for children using Schwartz formula;Glomerular filtration begins around the 6th wk of fetal life, the GFR of a child does not approximate adult values until 3rd yr of life Normal range in children: 80~120ml/min?1.73m2;7;肾功能正常期： BUN、SCr、CCr正常 CCr为80~120ml/(min·1.73m2) 肾功能不全代偿期： BUN、SCr正常， 　 CCr 为50~80ml/(min·1.73m2) 肾功能不全失代偿期：BUN、SCr增高， 　　 CCr 为30~50ml/(min·1.73m2) 肾衰竭期（尿毒症期）： SCr4mg/dl，并出现临床症状，如疲乏、不安、胃肠道症状、贫血、酸中毒等。 CCr为10~30ml/(min·1.73m2) ， 终末肾(ESRD)：如无肾功能替代治疗难以生存。 CCr 10ml/(min·1.73m2)， ;9;10;11;12;13;14;15;A 3-year old boy is seen in the ED with edema and shortness of breath. He was previously healthy, but his mother has noted worsening edema over the past 2 weeks and over the past 2 days he appears increasingly dyspneic. Physical examination reveals mild tachypnea, periorbital edema, decreased lung sounds in the bilateral bases, and pitting edema of bilateral lower extremities. CXR reveals bilateral pleural effusions. BP and CBC are normal. Urinalysis reveals 3+ protein. Serum albumin is markedly decreased with a value of 12g/L. A 24-hour urine collection reveals 3 grams of protein. ;Dx? DDx? Potential serious complications? Tx? Potential side effects after the treatment? The kidney biopsy of this patient would most likely reveal? ;Dx: Idiopathic nephrotic syndrome(simple type) DDx?: Idiopathic nephrotic syndrome(nephritic type), Secondary NS, Congenital NS Potential serious complications: Spontaneous bacterial peritonitis; Renal vein thrombosis; Hypovolemia; Varying degrees of renal insufficiency Tx: diet, Albumin(dextran); Furosemide; Prednisone; Low?Molecular?Heparin?Calcium; Calci