Doctor in 2017 my daughter was diagnosed by nephritic syndrome, case of neph syn since the age of 3, (2017), has had two relapses, but steroid responsive, patient was off steroids. Now with vomiting, pain in abdomen, create 2,1, reduced urine output to 0.8-1.2 ml/hr, renal failure not improved, urine routine 4+ alb, pus cells 3-4, rbc 30-35, urine showed yeast cells but culture neg, eosinophil in urine, 73 mg blood urea. Kidney biosphy was also performed which said, all the glomeruli are minimally involved and the immunofluorescence is negative. In the presence of nephrotic range proteinuria, the above features favour a minimal change disease with prominent tubular injury. The tubules show large zones of injury. Few reveal prominent isometric vacuoles. Some show granular appearance of the cytoplasm and occasional contain hyaline material. She was discharged on 27th as the condition was less severe, with 23 mg blood urea, ++++ alb in protein. And steroid started, prednisolone, but from yesterday the swelling increased, urine output decreased. Is it is normal for few days after starting steroids or should I consult the doctor immediately.
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Hello, your daughter has steroid responsive nephrotic syndrome with aki probably atn. This should improve with time, nothing to worry. Just maintain hydration, that is avoid dehydration, and no other medicine to be given without advice. But if despite giving adequate liquid, still urine output is low, see your doctor. Otherwise, I think, your on right track.
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The above history suggest a minimal change disease with acute kidney injury (aki). Steroids as planned is the right way forward. If you definitely feel the urine has reduced, then an immediate consult should be taken so that the doctor can adjust diuretics. One good way to assess response is by measuring daily weight. If significant weight gain occurs then it suggests the child is retaining water and needs attention. Regards.
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