Question

1. Provide 6 risk factors for a urinary tract infection in the pediatric patient
2. Compare the pathophysiology of nephrotic syndrome and glomerulonephritis

Answer 1

A urinary tract infection (UTI) in children is a fairly common condition. Bacteria that enter the urethra are usually flushed out through urination. However, when bacteria aren’t expelled out of the urethra, they may grow within the urinary tract. This causes an infection.

A child can develop a UTI when bacteria enter the urinary tract and travel up the urethra and into the body. The two types of UTIs most likely to affect children are bladder infections and kidney infections.

Risk factors include

Ø hospitalisation,

Ø recent catheterisation,

Ø common toilet usage,

Ø cleaning perineum from back to front,

Ø constipation,

Ø usage of tight underclothing,

Ø diaper usage,

Ø worm infestation,

Ø neurological abnormality,

Ø voluntary withholding of urine,

Ø reduced water intake constitute

Pathophysiology of nephrotic syndrome:

The kidney glomerulus filters the blood that arrives at the kidney. It is formed of capillaries with small pores that allow small molecules to pass through that have a molecular weight of less than 40,000 Daltons, but not larger macromolecules such as proteins.

In nephrotic syndrome, the glomeruli are affected by an inflammation or a hyalinization (the formation of a homogenous crystalline material within cells) that allows proteins such as albumin, antithrombin or the immunoglobulins to pass through the cell membrane and appear in urine

Albumin is the main protein in the blood that is able to maintain an oncotic pressure, which prevents the leakage of fluid into the extracellular medium and the subsequent formation of edemas.

As a response to hypoproteinemia the liver commences a compensatory mechanism involving the synthesis of proteins, such as alpha-2 macroglobulin and lipoproteins. An increase in the latter can cause the hyperlipidemia associated with this syndrome.

Pathophysiology of glomerulonephritis:

Glomerulonephritis (GN) comprises a specific set of renal diseases in which an immunologic mechanism triggers inflammation and proliferation of glomerular tissue that can result in damage to the basement membrane, mesangium, or capillary endothelium. .