what treatment of chronic renal failure in children

Children with chronic renal failure treatment - eating right
When children with glomerular filtration to the normal 50%, the growth rate in children declined, mainly due to insufficient caloric intake. Though understanding of renal insufficiency, the calorie intake is, but, as far as possible, so that caloric intake as well as or higher than the children in the age group. Available without restriction of carbohydrates to increase calorie intake in the diet such as sugar, jam, honey, glucose polymers and fat, such as medium-chain triglyceride oil, subject to the patient can tolerate.
Urea nitrogen is higher than 30mmol / L (80mg/dl) used in patients with nausea, vomiting and anorexia, these can be back to limit protein intake and ease. Due to children with renal failure, they still need a certain amount of protein used for growth, so the protein 1.5g / (kg · d), and should be given to high-quality protein (eggs and lean meat), such as eggs contain large amounts of essential amino acids, milk, followed by meat, fish, chicken and poultry. Milk phosphorus is too high, not appropriate to use, have to use glucose, peanut oil, a type of food to supplement the heat.
Children with renal insufficiency due to inadequate intake or loss of dialysis, there may be water-soluble vitamin deficiency should be routine supplementation. If the trace elements iron, zinc deficiency is also required to supply fat-soluble vitamins such as A, E, K, you do not need to supplement.
Children with chronic renal failure treatment - water and electrolyte handling
Renal insufficiency in children, rare to be limited into the amount to be adjusted due to brain "thirst center", unless it shall be developed to end stage renal failure with dialysis.The vast majority of children with renal insufficiency with the appropriate diet to maintain normal sodium balance. Some patients due to anatomic abnormalities, renal insufficiency, urinary loss of sodium to be supplemented by the dietary sodium; anti-This patient has high blood pressure, edema, or congestive heart failure need to limit sodium, sometimes combined with furosemide, a 4mg / (kg · 24h).
Due to excessive intake of potassium in the diet, lack of severe acidosis or aldosterone (nearly glomerular damage to the device), even with moderate renal insufficiency may also occur high blood strive disease, but in the vast majority of renal function insufficiency in children can be maintained to strive for balance, such as further deterioration of renal function, dialysis treatment to be done. Hyperkalemia may first try to control the intake of potassium in the diet plus oral alkaline material or lowering the potassium resin (sodium polystyrene sulfonate, Kayexalate) treatment.
Children with renal insufficiency, almost all of the acidosis, generally do not need to deal with, in addition to the 100 serum bicarbonate less than 20mmol / L, shall be corrected with sodium bicarbonate.
Treatment of children with chronic renal failure - renal osteodystrophy
Hyperphosphatemia, hypocalcemia, parathyroid endocrine level rise and increased serum alkaline phosphatase activity, often complicated by renal osteodystrophy.Generally less than 30% of the glomerular filtration rate is low to normal serum phosphorus levels rise. Serum calcium decreased four like next to the secondary hyperthyroidism. The hyperphosphatemia available phosphorus low dietary control can also be used calcium bicarbonate or oral antacid in order to promote the discharge of phosphorus from the intestine. The children also should be noted that aluminum toxicity, regular monitoring of serum aluminum levels.
Severe renal insufficiency and Vit.D the lack of Vit.D for continued hypocalcemia, X-ray showed rickets and serum alkaline phosphatase activity increased.
Treatment of children with chronic renal failure - anemia
Hemoglobin stability of the majority of patients in the 60 ~ 90g / L (6 9g/dl), without blood transfusion, such as hemoglobin less than 60g / L, accidentally entered the red blood 10ml/kg (a small amount can reduce the danger of blood circulation overload.)
Treatment of children with chronic renal failure - Hypertension
Hypertensive emergencies sublingual nifedipine or intravenous injection of diazoxide buck hydrochloride (5mg/kg, maximum dose 300mg, injected within 10 seconds).Severe hypertension with blood circulation overload to furosemide (2 4mg/kg, speed for 4mg/min). Renal insufficiency, should be more careful application of sodium nitroprusside, can be toxic thiocyanate salt accumulation.