Pediatric hypochlorite azotemia syndrome

Introduction to low chloride azotemia syndrome in children Hypochloremicazotemia syndrome, also known as Blum syndrome, Blum-vanCaulaerlt syndrome, renal hypoxia syndrome, pre-renal failure syndrome, pre-renal uremia, acute renal failure It is a common clinical syndrome with broad and narrow meanings. Acute renal failure in the narrow sense refers to acute tubular necrosis, while generalized acute renal failure refers to the same clinical syndrome caused by multiple causes. We divided emergency renal failure into three categories: prerenal renal failure; renal renal failure; post-renal renal failure. For various reasons, renal perfusion is insufficient to cause hypochloridic azotemia syndrome, which is prerenal renal failure. basic knowledge The proportion of illness: 0.005% Susceptible people: children Mode of infection: non-infectious Complications: coma, uremia, hyperkalemia

The cause of low chloride azotemia syndrome in children

(1) Causes of the disease

Hypochlorinated azotemia syndrome is caused by insufficient renal perfusion for various reasons. Insufficient renal perfusion secondary to the following conditions can lead to the symptoms: 1 reduction in cardiac output; 2 blood loss; 3 hypotension; 4 dehydration syndrome; 5 postoperative period; 6 late stage tumor; 7ADH secretion syndrome; 8 with vasoconstrictor, common causes of prerenal renal failure are vomiting, diarrhea, dehydration, major bleeding, burns, etc., can also be seen in Severe edema and ascites (relative lack of blood volume).

(two) pathogenesis

Although there were no organic lesions of the kidney for various reasons, the production of non-protein nitrogen was not reduced, and non-protein nitrogen excreted via the kidney was affected, and azotemia and hypochloremia were formed.

Prerenal renal failure is a functional renal failure. The blood volume in the body is reduced due to various reasons, resulting in a decrease in blood flow to the kidneys. The kidneys have a normal protective response to the reduction of circulating blood volume. Yes, although there is renal insufficiency, the structure of the kidney is damaged, mainly due to the decrease of blood perfusion of the kidney, which leads to a decrease in the filtration rate of the glomerulus, which reduces the excretion ability of the kidney, and causes oliguria or anuria. Symptoms cause accumulation of water, electrolytes and metabolic waste in the body.

Prevention of hypochloridemia in children

It is the prevention and treatment of various causes of this disease, such as positive correction of dehydration and blood loss; in the postoperative period, in the late stage of tumor disease, when vasoconstrictor is used, prevention of renal perfusion is caused by this disease.

Complications of low chloride azotemia syndrome in children Complications coma uremia hyperkalemia

Severe exhaustion, convulsions and coma, severe cases can cause renal parenchymal damage, uremia, hyperkalemia, congestive heart failure, can cause death.

Symptoms of hypochlorousemia syndrome in children Common symptoms Hyperkalemia, oliguria, fatigue, nitrogen balance, drowsiness, coma, edema, anorexia, convulsions, nausea

1. Mainly manifested as fatigue, anorexia, nausea, vomiting, oliguria, difficulty breathing, arrhythmia, pulmonary edema, and progression from lethargy to severe exhaustion, polydipsia, convulsions and coma.

2. EKG has a change in hyperkalemia.

Examination of children with hypochloridemia syndrome

Can be seen anemia, leukocytosis, thrombocytopenia, hyperazoemia, hyperphosphatemia, high creatinine and uric acid, hyponatremia, hyperkalemia, reduced prothrombin consumption, less urine and increased specific gravity, can There is albuminuria.

Should be X-ray, ECG, brain CT examination.

Diagnosis and diagnosis of low chloride azotemia syndrome in children

Combined with the cause of the disease, clinical manifestations and related laboratory tests to make a diagnosis.

Different from renal azotemia, there is a primary cause, and the history can help identify.

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