Treatment with water and electrolytes in children with renal insufficiency rarely requires a limited intake, because there is a brain "thirst center" to regulate, unless developed to End Stage Renal Disease, Dialysis is required. Most children have normal diet to maintain normal sodium balance when they have renal insufficiency. Some patients with renal insufficiency due to anatomical abnormalities, loss of large amounts of sodium from urine, dietary supplementation of sodium; Otherwise, this patient with hypertension, edema or congestive heart failure should be limited sodium, and sometimes combined with furosemide, 1-4 mg / (kg. 24 h).
Due to excessive potassium intake in the diet, severe acidosis, or aldosterone deficiency (near glomerular dysfunction), hyperglycemia can occur even in moderate renal insufficiency, but most children with renal insufficiency can maintain an upstream balance, such as further deterioration of renal function, dialysis is required. Treatment. Hyperkalemia can be treated with a controlled diet of potassium intake plus oral alkaline or potassium-reducing resin (sodium polystyrene sulfonate, Kayexalate).
Almost all children with renal insufficiency have acidosis, generally do not need to deal with, in addition to 100 serum bicarbonate less than 20 mmol / L, it is necessary to use sodium bicarbonate to correct.
Renal osteodystrophy is often associated with hyperphosphorus, hypocalcemia, elevated parathyroid endocrine levels and elevated serum alkaline phosphatase activity. Generally, when the glomerular filtration rate is below 30% of normal level, serum phosphorus level rises. Serum calcium decreased, followed by hyperparathyroidism with four parathyroidism. Hyperphosphorus can be controlled by a low-phosphorus diet, or by taking calcium bicarbonate or antacid orally to promote phosphorus excretion from the intestine. Children should also pay attention to aluminum poisoning. Serum aluminum level should be monitored regularly.
Serious renal insufficiency and Vit.D deficiency, Vit.D for continuous hypocalcemia, X-ray showed rickets and elevated serum alkaline phosphatase activity.
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