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A 4years old child with nephritic syndrome is being treated with corticosteroid therapy. A nurse reviews the laboratory reports of the child's urine to evaluate if the treatment has been effective. Which of the following should decrease?

A 4years old child with nephritic syndrome is being treated with corticosteroid therapy. A nurse reviews the laboratory reports of the child's urine to evaluate if the treatment has been effective. Which of the following should decrease? Correct Answer Proteinuria

Concept:

  • Nephritic syndrome or glomerulonephritis is inflammation of glomeruli due to infection or autoimmune reactions in the body. In other words, the antigen-antibody reaction leads to inflammation of glomeruli hence Nephritic syndrome.


Key PointsClinical manifestations include:

  • Gross hematuria that is blood is visible in the urine
  • Proteinuria i.e. up to 3.5gm per day. Hence it is one of the most important indicators of tracking the effectiveness of the treatment (Hence option 3 is correct).
  • Dark smoky cola-colored urine
  • Low urine pH
  • Increase specific gravity of urine
  • Azotemia- Increased BUN and creatinine 
  • Oliguria or anuria
  • High blood pressure and swelling of the brain may produce headaches and visual disturbances.


Important PointsCauses are Group A beta-hemolytic streptococci infection, immunological or autoimmune disease, this can occur following a throat infection or impetigo.

Management:

  • ACE inhibitors such as Benzapril and ramipril to treat hypertension
  • Corticosteroids to control the immune system like cyclosporin
  • Cholesterol reducing medications like statins
  • Anticoagulants such as heparin
  • Diuretics that increase kidneys' fluid output like furosemide.

Additional Information

  • Glycosuria is described as the presence of glucose in the urine which is one of the clinical manifestations of Diabetes Mellitus.
  • Polyuria: is characterized by excessive urination though out the day and night which may be a result of excessive consumption of fluids or an underlying disease such as Diabetes insipidus and Diabetes mellitus.
  • Hematuria is the presence of blood in the urine which may be a result of kidney infection, UTI, and pyelonephritis.

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