Bøger af Abir Boussetta

Chronic kidney disease (CKD) is defined by the presence, for more than 3 months, of markers of renal impairment, which may be morphological, histological or urinary abnormalities, or an abnormal GFR. CKD is classified into stages of increasing severity according to the level of glomerular filtration rate (GFR) and proteinuria.CKD has many etiologies, but is dominated by malformative uropathies. The main risk of CKD is progression to end-stage renal disease (ESRD), whatever the underlying etiology. As in the adult population, CKD can remain silent for a long time; however, early detection enables appropriate management of complications as soon as they appear, with the aim of slowing progression to ESRD. The role of the pediatric nephrologist is to confirm CKD, to clarify the etiological diagnosis and any complications, and then to monitor the child according to the stage of CKD. Psychological support for the child, parents and siblings is mandatory, as is social assistance.

Nephrotic syndrome is a relatively common nephrological pathology in paediatrics. The corticosteroid-sensitive form is frequently diagnosed easily, and generally evolves favorably under well-managed treatment.The challenge lies above all in corticoresistant forms, which frequently progress to chronic end-stage renal failure. Early treatment and management are imperative to ensure favorable short- and medium-term outcomes.

Hemolytic uremic syndromes are a heterogeneous group of diseases. The histological lesion at the origin of the different clinico-biological signs is the thrombotic microangiopathy. The positive diagnosis is based on the triad of mechanical hemolytic anemia, thrombocytopenia and renal failure. Hemolytic uremic syndrome following diarrhea with enteroinvasive germs, mainly Escherichia Coli, is the most frequent form in children. Other forms of hemolytic uremic syndrome are rarer and their positive diagnosis may be difficult in some cases. Only prompt management can improve the prognosis of the disease.

Reflux nephropathy largely follows intrarenal reflux of infected urine. However, this mechanism is certainly not unequivocal and lesions can occur without reflux being present. The term reflux nephropathy could therefore be replaced by reflux nephropathy, meaning that reflux is associated with other phenomena of pressure variations, immunological, inflammatory and ischemic phenomena.Early and adapted management could slow down the evolution of chronic renal disease.