Specialist in pediatrics - Dr. Mehdi Afshari, specialist in newborns, children and adolescents

Specialist for all children

Kidneys, this pair of small bean-shaped organs, play a vital role in maintaining the health of the whole body. They not only filter waste materials and toxins from the blood and excrete them in the form of urine, but also play a role in regulating blood pressure, producing red blood cells, and maintaining the balance of electrolytes and body fluids.

In children, whose body systems are growing and developing, kidney health becomes doubly important. When kidney problems occur in children, the need for specialized and careful care by a pediatric specialist becomes critical.

Who is the specialist of all children?

The superspecialist of all children is a doctor who goes through a long and precise training path to reach this specialized degree:

Professional medical doctorate: after completing the general medicine course

Pediatric specialty (Pediatrician): Completion of a specialized course in pediatric medicine, which provides a broad foundation in general pediatric health care.

Pediatric subspecialty: This subspecialty course focuses on the diagnosis, treatment, and management of kidney and urinary system diseases in infants, children, and adolescents.

These specialists gain in-depth knowledge of the physiology of the developing kidney, congenital kidney diseases, and the management of chronic and acute kidney problems in this sensitive age group.

This expertise allows them to take a holistic view of kidney problems in children, which often have different causes, manifestations and treatment responses than adults.

When should you refer to a pediatric kidney specialist?

Parents may feel the need to refer to a pediatric specialist when faced with certain symptoms or diagnoses in their child. Some of the most common reasons for visiting this specialist are:

Frequent urinary tract infections

More than one febrile urinary infection in young children.

Urinary tract infections that do not respond to usual treatments.

Urinary tract infections with structural abnormalities in the kidney or bladder.

Congenital anomalies of kidney and urinary system

Problems diagnosed before birth or in infancy, such as hydronephrosis (enlargement of the renal pelvis), vesicoureteral reflux (VUR), polycystic kidney, or horseshoe kidney.

Abnormalities that may require long-term follow-up or surgical intervention.

The presence of blood in the urine (hematuria)

Seeing blood in the urine (macroscopic hematuria) or the presence of blood in the urine test (microscopic hematuria), the cause of which is not known.

Presence of protein in urine (proteinuria)

Presence of protein in urine in stable or high amounts.

Nephrotic syndrome: a condition in which large amounts of protein are excreted through the urine and lead to swelling (edema) in the body.

High blood pressure (hypertension)

High blood pressure in children, especially if the cause is unknown, can often be caused by kidney problems.

Kidney stones

Diagnosis or history of kidney stones in children.

Kidney failure (acute or chronic)

Acute renal failure: Sudden failure of the kidneys, which can be caused by severe dehydration, infections, or medications.

Chronic kidney failure (CKD): Gradual decline in kidney function over time. Pediatric kidney specialist plays a vital role in managing CKD, delaying disease progression, managing complications and planning for dialysis or kidney transplant.

Electrolyte and acid-base disorders

Stable problems in the levels of sodium, potassium, calcium, phosphorus or acid-base balance in the body, the cause of which is not known.

Growth and development problems associated with kidney disease

Growth delay and short stature in children with chronic kidney disease.

Diagnosis and treatment process

All pediatric specialists use a comprehensive approach to evaluation, diagnosis and treatment:

Detailed medical history

Collecting complete information about family history of kidney diseases, history of pregnancy and birth, medications, and current symptoms of the child.

Full physical examination

Including accurate measurement of blood pressure, checking the presence of edema (swelling), examining the abdomen and other related examinations.

Specialized diagnostic tests

Blood tests: check kidney function creatinine, BUN, electrolytes, protein, and other disease markers.

Urinalysis: including complete urinalysis (UA), urine culture, and measurement of urine protein and creatinine.

Kidney and bladder imaging

Kidney and bladder ultrasound: to evaluate the size, shape and structure of the kidneys, the presence of abnormalities and stones

Kidney nuclear scan: to evaluate kidney function and the presence of scars caused by infections.

Kidney biopsy: in certain cases, sampling of kidney tissue for definitive diagnosis of glomerular diseases or other kidney diseases.

Treatment planning

Based on the diagnosis, the pediatric specialist formulates a specific treatment plan that may include:

Pharmacotherapy

Includes antibiotics (for infection), blood pressure control drugs, immunosuppressive drugs (for inflammatory kidney disease), and vitamin D and calcium supplements.

Diet management

Specific dietary recommendations for blood pressure control, protein elimination, and electrolyte management.

Supportive care

Management of body fluids, regulation of electrolytes.

Dialysis: In cases of advanced acute or chronic kidney failure, blood dialysis (hemodialysis) or peritoneal dialysis may be required.

Kidney transplant: To treat chronic kidney failure in the final stages, kidney transplant is the best long-term treatment option. All children's specialist has a central role in the evaluation of candidacy for transplant and post-transplant management.

Collaboration with other specialists: such as pediatric surgeons (to correct urinary abnormalities), nutritionists, and the transplant team.

The role of prevention and education

In addition to treatment, the specialist for all children also emphasizes prevention and education:

Education of parents: about the importance of drinking enough water, urinary hygiene, and warning signs of kidney problems.

Regular monitoring of children at risk: such as children with a family history of kidney disease or congenital kidney abnormalities.

Early detection of hypertension: and its management to prevent kidney damage.

Summary

Dr. Mehdi Afshari All children's specialist plays a vital role in maintaining the health of one of the most important body systems in children. With their deep expertise in the diagnosis, treatment and management of a wide range of kidney diseases, from simple urinary tract infections to kidney failure, they help children lead healthy and productive lives. Worrying is the key to successfully managing these disorders and ensuring a healthy future for our children.

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