Pediatric Nephrology & Hypertension

In addition to general nephrology, we have two Board-certified physicians (Dr. Bland and Dr. Horinek) who specialize in pediatric nephrology. In addition, our entire staff recognizes the importance of lowering high blood pressure in children. Studies indicate that children with hypertension grow to become hypertensive adults with increased risk of cardiac problems. Pediatric nephrology is the study of kidneys and their related medical conditions as they pertain to children.

Childhood Nephrotic Syndrome

The cause of this syndrome is unknown, but the good news is that it is not itself a disease. However, Childhood Nephrotic Syndrome can be the first sign of a disease that damages the tiny blood-filtering units (glomeruli) in the kidneys. The syndrome can occur at any age, but is most common between the ages of 1-1/2 and 8 years. In addition, it seems to affect boys more often than girls. If your child is experiencing any of these signs, contact us to schedule an appointment.

Warning Signs

High levels of protein in the urine
Low levels of protein in the blood
Swelling resulting from the buildup of salt and water (edema)

To diagnose childhood nephrotic syndrome, we may ask for a urine sample to check for protein, or we may ask for a 24-hour collection of urine for a more precise measurement of the protein and other substances in the urine. In some cases, we may need to examine a small piece of the kidney under a microscope (biopsy) with a long needle passed through the skin. It is usually performed while the child is awake, using calming drugs and a local anesthesia. General anesthesia is used in very rare cases where surgery is required.

Minimal Change Disease

The most common form of nephrotic syndrome, minimal change disease may occur in children with normal or nearly normal biopsies. If your child is diagnosed with this disease, we may prescribe prednisone, which stops the movement of protein from the blood to the urine. Since there may be side effects, it is essential that you discuss this with our specialist. In addition, sometimes a diuretic is prescribed to reduce swelling and help the child urinate. When the protein is no longer present in the urine, the dosage of prednisone will be reduced. Some children never get sick again, while others develop swelling and protein in the urine following viral illnesses. As long as he/she responds to medication and the urine returns to normal, he/she has an excellent long-term outlook without kidney damage.

In about 20 percent of the children who have a kidney biopsy, scarring or deposits on the glomeruli are revealed. These diseases damage the tiny filtering units and must be treated in order to avoid long-term kidney damage.