Pediatric Kidney Transplant Specialist in Delhi

Dr. Sidharth Kumar Sethi

Kidney & Urology Institute

He was trained as a Fellow (International Pediatric Nephrology Association Fellowship) and Senior Resident in Pediatric Nephrology at All India Institute of Medical Sciences and Division of Pediatric Nephrology and Transplant Immunology, Cedars Sinai Medical Centre, Los Angeles, California. He has been actively involved in the care of children with all kinds of complex renal disorders, including nephrotic syndrome, tubular disorders, urinary tract infections, hypertension, chronic kidney disease, and renal transplantation. He has been a part of 8-member writing committee for the guidelines of Steroid Sensitive Nephrotic Syndrome and Expert committee involved in the formulation of guidelines of Pediatric Renal Disorders including Steroid Resistant Nephrotic Syndrome and urinary tract infections. He has more than 30 indexed publications in Pediatric Nephrology and chapters in reputed textbooks including Essential Pediatrics (Editors O.P. Ghai) and “Pediatric Nephrology” (Editors A Bagga, RN Srivastava). He is a part of Editorial Board of “World Journal of Nephrology” and “eAJKD- Web version of American Journal of Kidney Diseases”. He is a reviewer for Pediatric Nephrology related content for various Pediatric and Nephrology journals

	Medical Qualification	European Board Certification (Pediatric Nephrology):   November 2020 Fellow (Indian Academy of Pediatrics)       2019   Fellow (American Society of Nephrology)       2018   Certification Exam: Pediatric Nephrology   Indian Society of Pediatric Nephrology       2010   Fellowship: International Society of Nephrology   Cedars Sinai Medical Centre, Los Angeles, California   2008-2009   Fellowship: International Pediatric Nephrology Association   All India Institute of Medical Sciences, New Delhi   2007-2008   MD Pediatrics   University College of Medical Sciences, New Delhi   2003-2006   MBBS   Maulana Azad Medical College, New Delhi   1997-2003
	Department Institute	Kidney & Urology Institute
	Expertise	» Pediatric Nephrology » Kidney Replacement Therapy including kidney transplantation

	Awards & Accomplishments
	Part of Team that performed India's First Pediatric ABO Incompatible Renal Transplantation
	S.S. Manchanda National Neonatology		2006		Research work on ‘Estimation of gestational age by anthropometry’
	Best Oral Paper presentation		2007		"Randomized Controlled Trial on Efficacy and Safety of Cyclosporine versus Tacrolimus in Children with Steroid Resistant Nephrotic Syndrome" at XIX National Conference of the Indian Pediatric Nephrology Group, Hyderabad
	Best Oral Paper presentation		2008		Anti Factor H Antibodies in Hemolytic Uremic Syndrome  and a novel therapy” at XX National Conference of the Indian Pediatric Nephrology Group 2008, Pune
	Outstanding Contributions to the Science of Paediatric Nephrology Dr. Sethi at Medanta, The Medicity is the leading Pediatric Nephrologist providing diagnostic and treatment services for children with conditions of the kidney especially Nephrotic syndrome, Glomerular disorders, rare tubular disorders and Chronic Kidney disease. Our team is the leading dialysis and renal transplant service centre for children. Dr. Sethi & team believes in personalized care that focuses on individual patient and family needs. Our team understands the challenges many of our families face when trying to access the care they need. Our caring goes beyond diagnostics and treatment. Our team is nationally recognized for their innovation, experience, dedication and expertise. We have the newest dialysis technology inpatient and outpatient, and provides comprehensive kidney transplant care to children of all ages.		Feb 2014		Awarded by Case Western Reserve University, Cleveland, Ohio, USA Call Now: 0124-4141414 Visit: www.pediatricnephrologyindia.com You can also search for: Pediatric Nephrology India, Best Pediatric Nephrologist in India, Best Pediatric Nephrologist in Gurgaon, Best Pediatric Nephrologist in Delhi, Child Kidney Specialist in Delhi, Child Kidney Specialist in Gurgaon, Child Kidney Specialist in India, Child Kidney Doctor in India Child Kidney Doctor in Delhi, Child Kidney Doctor in Gurgaon, Pediatric Dialysis Specialist in India, Pediatric Dialysis Specialist in delhi, Pediatric Kidney Transplant Specialist in Delhi, Nephrotic syndrome Specialist in India, Nephrotic syndrome Specialist in Delhi, pediatric nephrologist in delhi, best pediatric nephrology doctor in india, pediatric kidney doctor in india, Best Child Kidney Specialist in Delhi, Best Pediatric Nephrologist in Delhi, best paediatric kidney nephrologist in india, best child kidney doctor in india, Best Child Kidney care in delhi, pediatric nephrology,

Best Pediatric Nephrologist in India

Nephrotic Syndrome

Most people have two kidneys, one on either side of the body just beneath the ribcage. Healthy kidneys filter the blood and allow small particles of waste products and water to be excreted as urine. Kidneys also play important role in the control of blood pressure, maintenance of bone health and formation of red blood cells.

What is nephrotic syndrome?

Nephrotic syndrome occurs when the kidneys leak large amounts of protein (especially albumin) into the urine. It is these proteins which is mainly responsible for holding water in the blood vessels, and when they are lost in urine, their level decreases in the blood which causes the water to come out of the blood vessels and cause swelling (edema).

What causes Nephrotic Syndrome?

In most cases, the exact cause of nephrotic syndrome is not known. There is no relationship with diet or socioeconomic status of the family. It is non-infectious and does not transfer to other family members

What are the symptoms?

The most common symptom is swelling (edema). It first appears on the face, especially around the eyes which is most prominent in the morning when the child gets up and decreases by the evening.

Other symptoms include: Frothy urine, weakness and tiredness, passing less urine than usual, recurrent infections, diarrhoea.

What is the treatment?

Prednisolone (steroid) is the drug of choice when the child is first diagnosed. Most children respond to this drug with disappearance of the protein in the urine and loss of swelling within 1–2 weeks (we call this REMISSION). Other drugs like diuretics, ACE inhibitors, etc may be required for symptomatic treatment.

Those who do not respond to steroids are given second line drugs like Cyclophosphamide, MMF, Levamisole and other immunomodulators as decided by your doctor according to the individual patient profile.

Duration of treatment: First episode is treated for 3 months and subsequent episodes are treated as decided by your physician.

What are the side effects of the treatment?

Common Side Effects of Steroids are:

• Decreased resistance to infections such as cough and cold
• Increase in appetite
• Flushed, swollen cheeks and stretch marks on the skin
• Rise in blood pressure
• Behavioral problems e.g temper tantrums, or mood changes.

However most of the side effects are reversible and wean off once the steroid is stopped.

Long term supervision and course of nephrotic syndrome

In most cases the child with nephrotic syndrome becomes completely well with prednisolone treatment, and there are very few who require second line treatment which includes immunomodulators and other drugs.

The child may remain well for several months or longer. During this period, the child should be regarded as being normal, and should not be made to feel different from other children.

In majority of cases, however, nephrotic syndrome recurs. The recurrence is indicated by appearance of swelling around the eyes, which, if untreated, gradually increases to involve the face, feet, legs and abdomen, and in such conditions, doctor should be consulted immediately. Relapses are common in early childhood but decrease with age.

More than 90% of children with nephrotic syndrome go into adulthood with their kidneys functioning normally.

What are parents expected to do at home?

1. Starting and stopping of medicines should be strictly done as advised by the doctor.
2. Daily urine protein monitoring by urine dipsticks till negative for three days then atleast thrice a week during remission.
3. Keep a diary of all urine results so that your doctor can review your child’s progress in clinic. The dose of Prednisolone and any other medications and other comments should also be recorded.
4. In remission phase immediately report to the doctor under following conditions:

• Swelling around the eyes
• Decreased urine output
• Urine protein 1+ or more for persistent 2–3 days
• Any sign of infection like cough, cold, coryza.

Here is an example of how to record your child’s progress:

Date Urine protein Prednisolone dose (mg) Comments/remarks 01/08/15 3+ 40mg Swelling+/urine output decreased 02/08/15 2+ 40mg Swelling+; cough+ 03/08/15 2+ 40mg Swelling+; cough+ 04/08/15 1+ 40mg Swelling+

Dietary advice for your child:

The child should be given a diet with enough proteins. High protein food items include milk and milk products, dal, chana, soyabean, eggs, meat and fish.

If the child is edematous, the doctor might advise salt restriction. Once the swelling disappears, the child can have his usual diet. It must be understood that salt has no role in the causation of nephrotic syndrome. No benefit can be expected by prolonged restriction of salt unless advised by the doctor for some other reason (e.g., if the blood pressure is high).

When is kidney biopsy required?

Very few children require kidney biopsy. Certain conditions in which children do not respond to daily treatment or have persistent gross hematuria, persistent hypertension, low complement level (C3 / C4) require kidney biopsy.

What immunizations are necessary?

Children who are on steroid medications and other immunosuprressives can become very unwell if exposed to CHICKENPOX or MEASLES, therefore they should be immunized for the same and also receive pneumococcal vaccine.

Live vaccines should not be given during a prolonged steroid treatment.

Call Now: 0124–4141414
Visit: www.pediatricnephrologyindia.com

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Understanding Urinary Tract Infections

This topic is intended to give the parents and caregivers a comprehensive overview of urinary tract infections (UTIs)-causes, signs and symptoms, diagnosis, treatment and potential future complications, so that they can lend a helping hand in building a better kidney health for their children.

What does the urinary tract consist of?

1. KIDNEYS -These are two bean shaped organs situated on either side of our back. They filter the blood off the wastes and produce urine.
2. URETERS -These are two tubes through which urine from the kidney travels down.
3. URINARY BLADDER –It is a bag which stores urine coming in from the ureters.
4. URETHRA –It is a thin tube from which urine comes out of the body whenever we urinate.

What’s a uti?

A UTI occurs when bacteria (germs) invade the urinary tract through infected urine. Overall, UTI is commoner in girls than boys, except in first year of life as structural problems of urinary tract at birth are seen more in boys putting them at a higher risk of UTIs.

A lower UTI involves infection of the bladder (cystitis) or urethra.

An upper UTI involves the kidney (pyelonephritis) and is more serious.

How would i come to know that my child has a uti?

UTI is common in babies and young kids. It is hard to pick up a UTI in them as they might have just a few non-specific signs like-

• Fever(>38°C)
• Vomiting
• Lethargy(tiredness)
• Irritability
• Poor feeding
• Crying on passage of urine
• Frequent bed wetting
• Increased thirst, soft sunken spot on head (due to dehydration-lack of enough water in the body)

Older kids may also complain -

• Burning/stinging sensation while peeing (dysuria)
• Increased frequency of urination
• Cloudy urine
• Desire to hold on urine to avoid pain

When to suspect a kidney infection?

• High fever spikes despite taking paracetamol
• Back pain
• Red/dark brown urine (hematuria)

Why does my child have recurrent uti?

Most kids adequately treated for UTI do not have a repeated infection. But some kids go on having recurrent UTIs even after complete treatment. It is important to pay attention to it as they might have a structural urinary tract problem like vesicoureteric reflux (VUR).

VUR is due to improper insertion of the ureters into the bladder. This causes backflow of urine from the bladder up towards ureters and sometimes into the kidneys whenever the child pees. It can result in serious kidney infection and irreversible kidney damage (by scarring), if not detected and treated early.

Some red flags to keep in mind-

• Any congenital urinary tract problem
• Family history of VUR or kidney disease
• History of neurogenic bladder (problems in fully emptying the bladder, poor urine flow) and/or chronic constipation
• Hypertension (high blood pressure), poor growth

What can i do to save my kid from a uti?

• Encourage your child to pee every 3-4 hrs and, prior to bathing and sleeping.
• Change your baby’s nappies frequently.
• Teach your kid not to hold on his/her urine.
• Try to avoid constipation.
• Make him/her drink plenty of water and other fluids.
• Girls should wipe off their bottoms from front to back after a bowel movement to avoid introduction of any germs from bowel into urethra.
• Boys should gently clean the area below their penile foreskin as far as possible without forcing it back. Some boys with recurrent UTIs may need to have their foreskin incised (circumcision).
• If your kid has neurogenic bladder, double voiding (going to toilet twice- urinate once standing and then sitting) can help.

Seeking medical advice

If you suspect that your child has a UTI, consult your pediatric nephrologist immediately. The doctor would run the following tests on your kid’s urine sample to detect a UTI.

• Urine dipstick- It is a paper strip containing a reagent which changes color when it comes in contact with infected urine.
• Urine microscopy-It looks for the germs under a microscope.
• Urine culture-It grows and identifies the bacteria causing UTI on a separate medium in a lab and also tells which antibiotic will kill those bacteria.

Some special tests would be needed if your child has recurrent UTIs. These include-

• Ultrasound scan- A safe hand-held device emits sound waves and brings up pictures of the urinary tract on the screen.
• MCU/MCUG/VCUG-This test detects VUR. A dye is injected into the bladder via the urethra and serial X-rays are taken when your child urinates.
• DMSA scan- This test looks for any structural damage (scars) in the kidneys. A chemical is injected in the blood and images of urinary tract are taken by a camera.
• Blood urea, Serum creatinine-It is a simple blood test which determines the kidney function by various parameters.

Would my child get well?

Most UTIs get treated with a full course of antibiotics as prescribed by your doctor with no long-term sequelae. Paracetamol can be given to bring down the fever and pain. Avoid Ibuprofen (Brufen) if the child has a kidney problem or asthma. The child would start feeling better in a day or two but you should not stop the treatment at this stage. This is to ensure that all germs get killed to avoid any relapse. Your child can get back to school once he feels better as UTIs are not infectious (others won’t catch it).

Children with serious UTI/pyelonephritis need hospital admission.

Those with structural kidney problems (like VUR) and recurrent UTIs need regular follow-up visits to a pediatric nephrologist. They require prophylactic (for preventing UTI) antibiotics even if they do not have an active infection as repeated unnoticed mild infections can also cause irreversible scarring of the kidneys. This can lead to CKD (chronic kidney disease) wherein the kidney function will decline slowly over years and finally the patient might need dialysis or kidney transplant.

Seeing their own children suffer from chronic kidney disease is a stressful experience for parents. This holds true especially for kids with structural urinary tract problems (like VUR) at birth who remain undiagnosed (unidentified) for a long time, before which severe kidney damage has already set in. Parental awareness on this issue can be a very important prevention tool. We hope that this information helped you understand in depth the prevention, recognition and treatment of UTIs. For any queries or further concerns, please visit this website/consult your pediatric nephrologist today.

Call Now: 0124-4141414
Visit: www.pediatricnephrologyindia.com

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Pediatric Nephrology

 

Healthy Kidneys For Healthy Kids

Better kidney health for kids: What you should know!

Did you know that kidney diseases can start young? Literally. Unlike in the case of grown-ups, children can develop kidney diseases due to congenital defect, prematurity, or past hospitalization. "Also, children with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Needless to say that the sooner the issue is diagnosed, better can be the results," adds Dr Sidharth Kumar Sethi, Consultant, Pediatric Nephrology, Medanta, The Medicity, Gurgaon.

Early signs of kidney disease in kids

Early diagnose of kidney problem can help treat the ailment in time. Here are some signs that you should watch out for:

- Swelling around the eyes-face -feet- abdomen- whole body - Bed wetting (5 years or older) can be since birth or if the problem recurs after the child had stopped bed wetting for some time -Frequent urination - Crying during urination (in infants) - Painful urination (in older kids) - Unpleasant-smelling urine -Unexplained low-grade fever or recurrent fever episodes - Urine that is cloudy, bloody or dark brown - Persistent abdominal pain - Childhood renal stones - Frequent severe headaches - High blood pressure - Producing less urine -Producing more than 2 litre urine/ day -Poor appetite (in older children) - Poor eating habits, vomiting (in newborns & infants) - Slow growth or weight gain -Weak urinary stream, dribbling of urine stream - Weakness, excessive tiredness or loss of energy - Pale skin appearance

Protection plan

Have lots of water: To keep kidneys healthy, kids should stay hydrated- mostly by drinking water. Their pee should be pale in color, and they should drink more than usual when exercising especially under a hot sun. Kids should avoid nutrient-spiked drinks. Enough water is still the best and safest bet to meet their fluid needs.

Avoid sports drinks and processed: Today's diets are so extreme and unhealthy. Vitamin waters, sports or energy drinks, processed 'super-foods' are not nutritious and add to the risk of obesity in children.

Avoid too much protein: Protein intake should be in adequate amount. It is advisable to not make your kids indulge in too much protein.

Excess salt is bad: Too much sodium (in junk food, burgers, chips and street food) can contribute to high blood pressure. Eating more whole foods, choosing fewer processed foods- emphasizing those with made without added salt or sauce can help lower sodium intake. Cooking more at home can also help families slash sodium. Cut back on table salt and salty snacks.

Regular exercise: Increasing physical activity not only helps to reduce blood pressure, but it can help a child who is overweight reach and maintain a healthy weight. Sports and exercise programs at school may be good ways to increase the child's activity level.

Who should be screened?

Following children should be screened by a specialist for blood and urine test; growth and blood pressure:

• Family history of kidney disease
• Children born early or small-for-date
• Obese children; or those not growing well
• Abnormal antenatal ultrasound
• History of urine infection
• Abnormal urine examination

It is also extremely important for the health community to encourage pregnant females to undergo antenatal ultasonography. With the growing cases of kidney issues in children, it is crucial that we encourage and facilitate education, early detection and a healthy life style in children, starting at birth and continuing through to old age, to combat the increase of preventable kidney damage and to treat children early.

Call Now: 0124-4141414
Visit: www.pediatricnephrologyindia.com

You can also search for:

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Child Kidney Specialist in Gurgaon | Child Kidney Specialist in Delhi | Child Kidney Specialist in India

Healthy Kidneys For Healthy Kids

Better kidney health for kids: What you should know!

Did you know that kidney diseases can start young? Literally. Unlike in the case of grown-ups, children can develop kidney diseases due to congenital defect, prematurity, or past hospitalization. "Also, children with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Needless to say that the sooner the issue is diagnosed, better can be the results," adds Dr Sidharth Kumar Sethi, Consultant, Pediatric Nephrology, Medanta, The Medicity, Gurgaon.

Early signs of kidney disease in kids

Early diagnose of kidney problem can help treat the ailment in time. Here are some signs that you should watch out for:

- Swelling around the eyes-face -feet- abdomen- whole body - Bed wetting (5 years or older) can be since birth or if the problem recurs after the child had stopped bed wetting for some time -Frequent urination - Crying during urination (in infants) - Painful urination (in older kids) - Unpleasant-smelling urine -Unexplained low-grade fever or recurrent fever episodes - Urine that is cloudy, bloody or dark brown - Persistent abdominal pain - Childhood renal stones - Frequent severe headaches - High blood pressure - Producing less urine -Producing more than 2 litre urine/ day -Poor appetite (in older children) - Poor eating habits, vomiting (in newborns & infants) - Slow growth or weight gain -Weak urinary stream, dribbling of urine stream - Weakness, excessive tiredness or loss of energy - Pale skin appearance

Dr. Sidharth Kumar Sethi
Child Kidney Doctor in India

Protection plan

Have lots of water: To keep kidneys healthy, kids should stay hydrated- mostly by drinking water. Their pee should be pale in color, and they should drink more than usual when exercising especially under a hot sun. Kids should avoid nutrient-spiked drinks. Enough water is still the best and safest bet to meet their fluid needs.

Avoid sports drinks and processed: Today's diets are so extreme and unhealthy. Vitamin waters, sports or energy drinks, processed 'super-foods' are not nutritious and add to the risk of obesity in children.

Avoid too much protein: Protein intake should be in adequate amount. It is advisable to not make your kids indulge in too much protein.

Excess salt is bad: Too much sodium (in junk food, burgers, chips and street food) can contribute to high blood pressure. Eating more whole foods, choosing fewer processed foods- emphasizing those with made without added salt or sauce can help lower sodium intake. Cooking more at home can also help families slash sodium. Cut back on table salt and salty snacks.

Regular exercise: Increasing physical activity not only helps to reduce blood pressure, but it can help a child who is overweight reach and maintain a healthy weight. Sports and exercise programs at school may be good ways to increase the child's activity level.

Who should be screened?

Following children should be screened by a specialist for blood and urine test; growth and blood pressure:

• Family history of kidney disease
• Children born early or small-for-date
• Obese children; or those not growing well
• Abnormal antenatal ultrasound
• History of urine infection
• Abnormal urine examination

It is also extremely important for the health community to encourage pregnant females to undergo antenatal ultasonography. With the growing cases of kidney issues in children, it is crucial that we encourage and facilitate education, early detection and a healthy life style in children, starting at birth and continuing through to old age, to combat the increase of preventable kidney damage and to treat children early.

Call Now: 0124-4141414
Visit: www.pediatricnephrologyindia.com

You can also search for:

Pediatric Nephrology India,
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Best Pediatric Nephrologist in Gurgaon,
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Nephrotic syndrome Specialist in India

 Nephrotic Syndrome

Most people have two kidneys, one on either side of the body just beneath the ribcage. Healthy kidneys filter the blood and allow small particles of waste products and water to be excreted as urine. Kidneys also play important role in the control of blood pressure, maintenance of bone health and formation of red blood cells.

What is nephrotic syndrome?

Nephrotic syndrome occurs when the kidneys leak large amounts of protein (especially albumin) into the urine. It is these proteins which is mainly responsible for holding water in the blood vessels, and when they are lost in urine, their level decreases in the blood which causes the water to come out of the blood vessels and cause swelling (edema).

Dr. Sidharth Kumar Sethi
(Child Kidney Doctor in Delhi)

What causes Nephrotic Syndrome?

In most cases, the exact cause of nephrotic syndrome is not known. There is no relationship with diet or socioeconomic status of the family. It is non-infectious and does not transfer to other family members

.

What are the symptoms?

The most common symptom is swelling (edema). It first appears on the face, especially around the eyes which is most prominent in the morning when the child gets up and decreases by the evening.

Other symptoms include: Frothy urine, weakness and tiredness, passing less urine than usual, recurrent infections, diarrhoea.

What is the treatment?

Prednisolone (steroid) is the drug of choice when the child is first diagnosed. Most children respond to this drug with disappearance of the protein in the urine and loss of swelling within 1-2 weeks (we call this REMISSION). Other drugs like diuretics, ACE inhibitors, etc may be required for symptomatic treatment.

Those who do not respond to steroids are given second line drugs like Cyclophosphamide, MMF, Levamisole and other immunomodulators as decided by your doctor according to the individual patient profile.

Duration of treatment: First episode is treated for 3 months and subsequent episodes are treated as decided by your physician.

What are the side effects of the treatment?

Common Side Effects of Steroids are:

• Decreased resistance to infections such as cough and cold
• Increase in appetite
• Flushed, swollen cheeks and stretch marks on the skin
• Rise in blood pressure
• Behavioral problems e.g temper tantrums, or mood changes.

However most of the side effects are reversible and wean off once the steroid is stopped.

Long term supervision and course of nephrotic syndrome

In most cases the child with nephrotic syndrome becomes completely well with prednisolone treatment, and there are very few who require second line treatment which includes immunomodulators and other drugs.

The child may remain well for several months or longer. During this period, the child should be regarded as being normal, and should not be made to feel different from other children.

In majority of cases, however, nephrotic syndrome recurs. The recurrence is indicated by appearance of swelling around the eyes, which, if untreated, gradually increases to involve the face, feet, legs and abdomen, and in such conditions, doctor should be consulted immediately. Relapses are common in early childhood but decrease with age.

More than 90% of children with nephrotic syndrome go into adulthood with their kidneys functioning normally.

What are parents expected to do at home?

1. Starting and stopping of medicines should be strictly done as advised by the doctor.
2. Daily urine protein monitoring by urine dipsticks till negative for three days then atleast thrice a week during remission.
3. Keep a diary of all urine results so that your doctor can review your child’s progress in clinic. The dose of Prednisolone and any other medications and other comments should also be recorded.
4. In remission phase immediately report to the doctor under following conditions:
   • Swelling around the eyes
   • Decreased urine output
   • Urine protein 1+ or more for persistent 2-3 days
   • Any sign of infection like cough, cold, coryza.

Here is an example of how to record your child’s progress:

Date	Urine protein	Prednisolone dose (mg)	Comments/remarks
01/08/15	3+	40mg	Swelling+/urine output decreased
02/08/15	2+	40mg	Swelling+; cough+
03/08/15	2+	40mg	Swelling+; cough+
04/08/15	1+	40mg	Swelling+

Dietary advice for your child:

The child should be given a diet with enough proteins. High protein food items include milk and milk products, dal, chana, soyabean, eggs, meat and fish.

If the child is edematous, the doctor might advise salt restriction. Once the swelling disappears, the child can have his usual diet. It must be understood that salt has no role in the causation of nephrotic syndrome. No benefit can be expected by prolonged restriction of salt unless advised by the doctor for some other reason (e.g., if the blood pressure is high).

When is kidney biopsy required?

Very few children require kidney biopsy. Certain conditions in which children do not respond to daily treatment or have persistent gross hematuria, persistent hypertension, low complement level (C3 / C4) require kidney biopsy.

What immunizations are necessary?

Children who are on steroid medications and other immunosuprressives can become very unwell if exposed to CHICKENPOX or MEASLES, therefore they should be immunized for the same and also receive pneumococcal vaccine.

Live vaccines should not be given during a prolonged steroid treatment.

You Can Also Search For:
Pediatric Nephrology India
Best Pediatric Nephrologist in India
Best Pediatric Nephrologist in Gurgaon
Best Pediatric Nephrologist in Delhi
Child Kidney Specialist in Delhi
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Pediatric Dialysis Specialist in India
Pediatric Dialysis Specialist in delhi
Pediatric Kidney Transplant Specialist in Delhi
Nephrotic syndrome Specialist in India
Nephrotic syndrome Specialist in Delhi