Mention "nephropathy", many people will think about this disease and the elderly. However, in recent years, admitted to the pediatric department of nephropathy patients are obviously more up. Data show that the number of Chinese patients with chronic renal failure in children at an annual rate of 13%. Most children with nephropathy experts pointed out that the "external", in which drug the abuse is arch-criminal. How to give children the correct medication, treatment and avoid drug-induced nephropathy, parents must seriously study the "lesson".
The incidence of kidney disease in children increased
According to statistics, China has more than 200 million children with nephrosis. In recent years, the number of children with nephrosis has increased, and the number of children suffering from chronic renal failure has increased by 13% per year, of which about 70% are caused by acquired factors
Guangzhou No.1 People's Hospital, director of pediatric physicians by professor noted that chronic renal failure and acute renal failure caused by drugs incidence is higher in children than in adults, accounted for the first acute renal failure.
Take the Municipal Hospital of pediatrics as an example, the number of children suffering from kidney disease in recent days has doubled compared with the earlier years. "A few years ago, because of hematuria, the children who came to see each other had 5~6 cases per month, and now there are more than ten cases in one month.""
Careless use of drugs is the main reason
What is the reason for the increased incidence of nephropathy in children? On the one hand because in recent years, parents pay more attention to the health of children, more children nephropathy early diagnosis; on the other hand, a lot of parents in sick children let children take various drugs, or drugs, some ingredients together in excess, it is possible to harm to the child's kidney. In addition, some supplements and abuse of traditional Chinese medicine, but also easily lead to children's drug nephropathy.
"Although the kidney weight and body weight accounted for only 0.5%, but the blood flow for cardiac output from 20% to 25%, renal tissue per 100g admission blood about 350ml/min, so the dose of drugs into the kidney is relatively large, are susceptible to the toxic effects of the drug. The force also said that due to the glomerular capillary endothelial cells and renal tubular epithelial cell surface area, so there is a larger contact area with drugs, renal tubular epithelial metabolism, is easily affected by the drug. In addition, at present, some drug package insert, no detailed provisions dosage for children, only use discretion discretionary" or "under the guidance of a doctor medication and other vague tips or, is the age range is too large (two or three years old children to teenagers can use), these are for drug safety for children planted a huge risk.
Medication follows four principles
Yu Li said, strictly grasp the indications of drug use, to prevent abuse, is the most effective way to avoid the children of drug nephropathy.
Avoid the use of kidney damaging drugs
Child cold have a fever and other common diseases, drugs can not try not to use drugs, really need to take medicine, also must be used under the guidance of a doctor, try to avoid the use of antibiotics in renal toxicity, especially suspected renal insufficiency or kidney disease, it should choose drugs without obvious toxicity to the kidney.
The force lists some common drugs can cause kidney damage, including penicillin (such as methicillin, ampicillin), cephalosporins (such as ceftriaxone), aminoglycosides (such as kanamycin, gentamicin, kanamycin), sulfonamides, non steroidal anti-inflammatory drugs, antineoplastic drugs. "Some of the old antibiotics in the hospital are basically no, but because the price is cheap, many grassroots township hospitals, is still in use, these drugs can easily cause damage to the kidney, especially in children"
It is worth noting that there are antipyretic analgesics. Acetaminophen antipyretic analgesics is currently the most widely used, but the children under the age of 3 should be used with caution. Many of the children taking clinical Ganmaotong (including diclofenac sodium) hematuria after, so this kind of medicine should not be used in children.
In addition, indomethacin, Tabellae Aminophenazoni Phenacetini ET C affeini, Compound Aminopyrine Phenacetin Tablets, etc. a Antondin analgin, analgesics not for children.
Don't rush to take medicine when you are ill all your life"
Children are ill all the time, and some parents are too busy with their children to take medicine, and sometimes they don't even have many kinds of drugs under the guidance of doctors
General common diseases such as the common cold, have a fever, there are some rules, the entire course lasts 5 to 7 days is normal, during which children may have a fever repeatedly. Some parents worry that children have a fever will burn "bad", trying to get the fever down, such as children have a fever did not exceed 38.5 C and let the children eat a variety of antipyretics, even ignoring the drug, let the children eat several times a day antipyretics.
Yu Li said that the fever of the newborn, does not recommend the use of the drug fever, should take physical cooling; 1 to 3 months of age, as the condition needs according to the prescribed treatment; more than 3 months infants, body temperature more than 38.5 DEG C just need to take antipyretics.
Try not to use more than 3 drugs at the same time
The force had a more extreme example, children have a fever, he also let parents eat antibiotics, expectorant, cough syrup, and chlorpheniramine and other 5 kinds of drugs, the results of eating for fifth days, the children appeared hematuria.
Yu Li pointed out that the drug complex, between each other may be offset, and toxic effects were added, not only the curative effect is not good, there will be adverse reactions. Such as sulfa and vitamin C, can aggravate kidney poisoning; with the use of aspirin and penicillin, penicillin can reduce the antibacterial effect. As for penicillin, chloramphenicol, sulfonamides. Or, cephalosporin and gentamicin company, has the same risk.
At the same time, medication should avoid too large a dose of drugs, the course should be short, as far as possible not to use more than 3 kinds of drugs, continuous use of a drug for several days still no effect, should be based on the doctor's advice to replace drugs or treatment
Children should be careful with traditional Chinese Medicine
Some Chinese herbal medicine has renal toxicity clear, the improper application of adverse reactions will occur. The force points out that Chinese herbal medicine has the renal toxicity of several ten species. Among them, there are more reports of Tripterygium wilfordii, Akebia, Aconitum, kangfangchi, Aristolochia, trichosanthin, asarum, cantharidin, centipede, cinnabar, Chinaberry root. Cantonese love drink herbal tea, do not know the specific components of herbal tea also need to be careful. Some herbal tea can cause hemolytic anemia, cause hematuria, red blood cell rupture debris clogging the renal tubules, cause acute renal obstruction, hemolytic patients should avoid taking Scutellaria, Coptis, phellodendron and other traditional Chinese medicine. "As a pediatrician, we do not claim that the child to drink herbal tea, this approach brings the absolute risks outweigh the benefits"
Children with these symptoms should be timely medical treatment
The renal injury caused by drugs is difficult to detect, some parents of the child appeared edema, urine color abnormal phenomenon does not care, when have a fever, hematuria and other symptoms before treatment, often delayed treatment, even for the development of chronic renal failure.
How to find the problem as soon as possible? Force said: "if the children often feel fatigue, face color or yellow, eyelid or lower extremity edema, urine color change, frequent urination, urgency and hematuria and other symptoms, to timely medical treatment"
For infants who are still young, if the baby cries badly when urinating, the urine is cloudy, the color is too dark, is brown, also should arouse the attention of the parents
Once a child is confirmed to suffer from a drug-induced kidney injury, he or she should not worry too much if it is not seriously damaged
The force said the drug renal damage prognosis is generally good, and actively cooperate with medical treatment can be completely cured, and no sequelae. General hematuria confirmed by "alkaline urine" to "Detox rehydration", for serious cases of hematuria, to filter blood over replacement liquid, usually one or two be restored. Do not increase the risk of suffering from uremia in the future.