A lot of people
have urinary tract
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problems, and some
these are quite easy to treat.
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Some of them are not so easy.
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I hope if you have
an interest in this,
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that you will join us
for this program, as we'll be
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talking about some of
the very common ones, mainly
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in children, and we
think that you will enjoy our
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program on how to treat
these urinary tract problems.
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Welcome to Help
Yourself To Health
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With Dr. Agatha Thrash
of Uchee Pines Institute.
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And now here's
your host Dr. Thrash.
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Children handle urinary
tract problems quite well.
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I remember the
first patient that I had
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with a urinary tract problem.
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A little fellow probably
about 13 or 14 moths old.
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He had been born
with ureters that did
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not connect into the
bladder in a proper way.
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So of course a
very serious problem,
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and he had to be operated on,
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and as a part of
the treatment we used a
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cystostomy which was
going in just above the
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pubic bone and
putting a hole in the bladder
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so that we could
put a catheter in it,
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and that would enable him
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to pass his urine
through this catheter.
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The little
fellow seemed to always
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smell of urine, but that didn't
seem to bother him at all.
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He was so happy in the hospital,
and of course all the nurses
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and the doctors paid a
little close attention to him.
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Especially he
and I seemed to bond
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together really
well, so any time I
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walked on his
ward, he would just hold
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his hands up for
me to pick him up, so
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I would pick him
up and put him on my
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hip, and he would
walk with me around
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to do all of the
rounds I had to do.
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Eventually the time came
when we closed up the cystostomy
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and we were
going to send him home.
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So when he left, he
smelled all fresh and clean,
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and no more urine smell.
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He was very
happy and we were too.
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Except sad to say "goodbye".
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That young man is
now well into his forties
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and he is doing quite
well he has never had any more
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urinary tract problems.
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His little connections
function very nicely.
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He is hale and,
hardy and very healthy.
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Now we can start our urinary
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tract problems
even before birth, or as
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in the case of many
children at the bed.
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While a lot of children
are broken to the house,
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by the age of 18
months, there are some who
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require a great
deal longer than that.
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I have here Dr. Don Miller
who is going to talk with you
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about bed wetting problems.
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That's a serious
problem in some homes.
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What can you tell us
about what to do for it,
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and how it comes about.
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Well, it is
indeed a serious problem.
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When we have a
small animal like a dog,
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we usually put
their little nose in it
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and we spank them.
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and I will say
this, that spanking and
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punishing is not this cure for
a child who is still bedwetting.
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About 4% of children
still bed wet by the age of 12
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and punishing, will
only make the matters worse.
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As a matter of fact emotional
causes are one of the things
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that precipitate the bed
wetting, and so if a child
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is in a home
where there is turmoil,
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where there is anger,
where there is strife,
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that child may be more likely
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to be a bed wetter, so we
need to have peace in the home.
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It's pretty uncommon now days
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to have that peace in the
home, but we need to find that
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peace in the home.
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There are other
causes for bed wetting.
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One could be just
that the child was
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born with a smaller bladder.
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Now a good way to find out
whether that's the problem is,
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does the child urinate
frequently through the day.
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Basically if they have a
small bladder, it fills up,
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they've got to void,
fills up they've got to void,
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and that could
continue through the night.
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So we have to
make sure the child
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basically, as the evening starts
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wearing on, they
quit drinking fluids,
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really no fluids after
5 p. m. in the afternoon.
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They should drink plenty
during the rest of the day,
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but 5:00 p. m. quit the fluids,
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then make sure
that just before they go
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to bed they
void, it's purposefully
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"I don't need to go", go anyway.
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I remember in
Marine Corps Boot Camp,
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there was even at that time,
there were a couple of guys
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in my platoon that were
bed wetters, and they would be
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made to go into
the bathroom before
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they went to bed, and
void and then twice during the
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night they were
woken up by the fire watch,
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and made to go in there even
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if they didn't have
to go, they were made.
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That sort of
separated out those who
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were doing it just it
just to get out of the corps
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or something
because they didn't like
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getting woken up at night,
but that sometimes can't help.
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As a matter of fact,
they got a little device
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called a wee guard.
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Some type of little alarms,
that are placed on the child,
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and when they start to get wet,
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they send an alarm
that wakes the child up
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and they can go in and void.
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Which is not a bad idea.
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But probably the main cause
of bedwetting is food allergies.
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Some type of an allergy in their
system, in their environment
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that's causing them
to have this problem.
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and it's interesting to
note that usually if a parent
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has an allergy like
hives, or hay fever,
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or other types of allergies,
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It's more likely that
the child will have allergies
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and then it can
manifest itself in bed wetting.
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There are certain major
foods that lead to bed wetting:
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Probably the number one food,
which about 60% of children
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who bed wet after the age of
12 are allergic to cows milk,
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and I would say
probably all dairy foods.
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So that needs to be eliminated
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from the child's dietary.
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There are some other
thing that they could be taking
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chocolate, of course
if you take chocolate
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you are taking milk, so
it could be the chocolate
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although there are things in
the chocolate that irritate the
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bladder, which
could cause you to urinate
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when you don't want to,
there's also milk in there.
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Eggs and citrus, wheat,
grain, corn, and chicken
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some of these are good foods
but if a child is sensitive
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they need to stay away,
and what we recommend is
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a child withdraw these things.
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I'm going to
read this list slowly.
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If you have this
problem in your home,
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write down these and go on
what we call an elimination diet
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take all these
things away from them,
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for a period of a week or
two, probably at least 2 weeks
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and then add back
the ones that are good,
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Ok, you can make
that determination,
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but here is the list:
cow's milk, all dairy products,
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that means cheese, that means
ice cream, that means milk,
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that means high fat,
low fat, any fat, no fat
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whatever, none of that.
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Chocolate, eggs, citrus,
wheat, wheat is a major allergen
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Probably because it's one
of the earliest foods that we
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introduce into the child, and
because we don't properly cook
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our wheat products.
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The next one is
grains, we need to properly
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cook our grain products.
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Corn, chicken, meat, peanuts,
and fish, so eliminate those
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from the dietary,
and see if that does
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not take care of the problem.
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If that does take
care of the problem,
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then you know what it is.
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Add one back, which
might be a decent one
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If the problem does not
come back, you have found out
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what the problem was, and the
child is cured of their problem.
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Constipation can also
be a cause of bedwetting.
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Basically a constipated bowel
is pushing against the bladder
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which causes it to
not have as much volume
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and pushes out
urine in the night.
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So a child should
not be constipated.
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None of us
should be constipated.
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Of course we cure that
by making sure the child
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drinks plenty of
water, during the day
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and has a high fiber diet
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and stays away from
all those other things
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that cause constipation.
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Those highly
refined carbohydrates,
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and sugary junk foods.
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Have the child, when they
are going to the bathroom,
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urinating, have them
do the start stop thing.
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Basically it's almost
like the kegel exercises,
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they start the stream, then
consciously stop the stream,
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Start the stream,
consciously stop the stream.
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That will set up a
mental system in their minds
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that they are now
under mental control.
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Even when you are asleep
you are under mental control
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of this particular problem.
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I have learned that if a child
has been sick for a period of
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time, and they are
using a little hand urinal
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and they roll over
in bed and urinate,
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that sometimes sends a
signal to the brain that
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ok, you don't have to get up,
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just do it while
you are laying there
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That also goes for adults,
if you are somehow bedridden
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it could lead to a
little bit of incontinence
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in the
nighttime season later on.
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We've got to
visibly or consciously
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get up out of the bed
and go to the bathroom
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which is the best way.
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Outdoor exercise,
extremely important
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for a child who has
bedwetting problems.
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We find that
children with bedwetting,
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bed wet more in the winter time
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when they are not
quite as physically active
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than in the summertime, so
exercise has a large amount
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to do with bedwetting problems.
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Then one thing that I've
already mentioned we did there
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in boot camp,
that is not a bad idea.
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If the child goes to
bed at 8:30 at night,
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which is a good time
for a child to go to bed.
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You might want to wake
them at some specific time
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later on in the
night, just wake them up
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take them to the bathroom
and have them void then.
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It gets them into that
pattern, it might eliminate
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them going into the problem.
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These are some
simple things that we can do
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for a child, of course there
other things that can lead to
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bedwetting, a
urinary tract infection
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which Dr. Thrash will
be talking about, cystitis
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but these are some
simple things Dr. Thrash
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that I think might help a child.
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You mentioned
long cooking of grains,
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did you say enough to make
it so that I would be able to
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know how to feed my
child grains. Ok! Ok!
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Not just the child Dr. Thrash,
but even feeding us the grains.
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We don't cook our
grains well enough.
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A grain is a carbohydrate.
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A carbohydrate comes in a
number of different forms.
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We have sugars, we have
starches, we have fiber.
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It's the starches, which is
nothing more than a long chain
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of glucose molecules.
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If it is not
properly cooked or hydrolyzed
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these chains do not break
down, and these long chains
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can get into the
blood and circulate through
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the system, and these long
chains can cause real problems
00:11:05.24\00:11:08.73
in the system.
00:11:08.76\00:11:09.94
They can go into the brain
and cause little lacunar scars
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and anyone over 30 has a
brain full of lacunar scars.
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They can go down to
the kidneys and cause
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some type of problems there.
00:11:18.98\00:11:20.12
They can go into the bones.
00:11:20.18\00:11:22.00
They did an experiment they
fed a lactating woman a solution
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starch suspended in water,
she drank that, and within
00:11:26.99\00:11:30.29
a short period of time
they found that starch chains
00:11:30.32\00:11:33.59
in her blood, in her
breast milk, in her urine,
00:11:33.62\00:11:36.58
so we need to
cook our grains well.
00:11:36.61\00:11:39.49
Now what's cooking grains
well, even instant oats should
00:11:39.53\00:11:41.95
be cooked for a
half hour to 45 minutes.
00:11:41.98\00:11:43.98
I cook all of my
oatmeal at night in a crock pot
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all night long.
00:11:47.96\00:11:49.09
Rice, up to two to three hours.
00:11:49.13\00:11:51.06
Peoples say well how
can you eat it like that.
00:11:51.10\00:11:53.10
Well you got to make a
choice, you're going to have
00:11:53.14\00:11:56.06
the lacunar scars in your brain
00:11:56.09\00:11:57.89
or a little bit more mushy food,
00:11:57.92\00:11:59.46
If you take your
rice or your other
00:11:59.49\00:12:01.13
grains, you dextrinize it first.
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Put it in a hot skillet,
heat it up until you hear
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it start a little
sizzle, that will dextrinize,
00:12:06.30\00:12:09.75
that will keep it
from sticking together
00:12:09.78\00:12:11.43
as you are cooking it
and give a nice nutty flavor.
00:12:11.47\00:12:14.00
It's a whole lot healthier,
so I don't know if that helps.
00:12:14.04\00:12:16.46
You did some experiments
with cooking grains, didn't you?
00:12:16.50\00:12:18.89
We did and we found
that whole kernel wheat,
00:12:18.92\00:12:23.73
or whole kernel oats, required
about four to five hours
00:12:23.77\00:12:28.50
to completely cook them.
00:12:28.53\00:12:29.97
Corn grits which we like a lot
in the south, requires a good
00:12:30.01\00:12:34.24
four hours of cooking
in order to make them about
00:12:34.27\00:12:37.38
the consistency
of mashed potatoes.
00:12:37.41\00:12:40.16
Which is a very fine dish
when it's properly prepared,
00:12:40.19\00:12:45.75
and also a very healthful dish.
00:12:45.78\00:12:47.54
There are some other things
associated with bedwetting
00:12:47.58\00:12:53.41
that are far more serious.
00:12:53.44\00:12:54.82
One of those is epilepsy,
and of course that is very rare
00:12:54.86\00:12:59.25
but if you find that
your child's bed is wet,
00:12:59.28\00:13:03.18
and the bed is disheveled
quite a lot more than you think
00:13:03.22\00:13:07.69
the child usually does
with ordinary sleeping,
00:13:07.72\00:13:10.60
you might just check to see
if the child might be having
00:13:10.64\00:13:14.44
a seizure during the
night, a nocturnal seizures
00:13:14.47\00:13:18.07
are more common probably
than we might think they are
00:13:18.11\00:13:22.17
in children who are
going to have epilepsy.
00:13:22.20\00:13:25.43
Then of course it
can be associated with
00:13:25.47\00:13:28.67
juvenile diabetes, and
you want to check for that
00:13:28.70\00:13:33.07
if the condition
persists or worsens.
00:13:33.10\00:13:36.58
Then sometimes sleep walking
is associated with bedwetting
00:13:36.62\00:13:42.16
and speech disorders of various
kinds can also be associated
00:13:42.20\00:13:47.71
with bedwetting, not
that they are a cause,
00:13:47.74\00:13:50.15
but just that if your
child has some of these
00:13:50.18\00:13:52.56
other conditions, know that
they may have more difficulty
00:13:52.59\00:13:57.33
when they try to control
their incontinence at night.
00:13:57.36\00:14:02.09
Cystitis is an
important thing in children,
00:14:02.12\00:14:05.99
especially little boys,
little boys seem to have more
00:14:06.03\00:14:11.28
cystitis than little girls,
00:14:11.31\00:14:12.74
although little girls
can certainly have it.
00:14:12.77\00:14:16.20
I remember one little
girl who was put with,
00:14:16.24\00:14:19.66
I think her father had
either milk goats or milk cows
00:14:19.69\00:14:24.33
and they were put in a pasture
that did not have a gate.
00:14:24.36\00:14:28.97
So the little girl was
set there to mind the cows
00:14:29.00\00:14:32.58
in the pen while the older
members of the family were doing
00:14:32.62\00:14:37.52
something else, and she began
to notice that she couldn't
00:14:37.55\00:14:42.42
hold her urine long
enough to be able to get ready
00:14:42.45\00:14:46.09
to pass her urine, so she
began to wet her clothing.
00:14:46.13\00:14:49.70
After she smelled like urine
several days in a row her mother
00:14:49.74\00:14:55.15
said, what happening with
you, why are you smelling like
00:14:55.18\00:14:59.24
you have wet yourself,
and she said "well I am. "
00:14:59.27\00:15:02.28
I do wet myself and I
don't know why, I really try.
00:15:02.32\00:15:05.26
Then the mother realized that
she had an incontinence problem
00:15:05.30\00:15:10.64
due to cystitis.
00:15:10.67\00:15:12.42
So they began to check and
the doctor found that there
00:15:12.46\00:15:16.11
were puss cells and
bacteria in the urine,
00:15:16.14\00:15:19.71
and with proper treatment
the young lady was cured within
00:15:19.75\00:15:24.81
a short time.
00:15:24.84\00:15:25.81
So this can be and infection
of little girls as well,
00:15:25.82\00:15:30.82
but little boys tend to
have it more frequently,
00:15:30.85\00:15:33.52
and older women, so
it's mainly a problem
00:15:33.55\00:15:36.90
with little
boys and older women.
00:15:36.94\00:15:38.94
Older women because of
the short urethra, and because
00:15:38.98\00:15:42.11
of difficulties
with back infection
00:15:42.14\00:15:47.97
from a short urethra
and the perineal area.
00:15:48.01\00:15:51.66
But if a woman is
very careful and uses
00:15:51.69\00:15:55.51
a perineal pour
after every voiding
00:15:55.54\00:15:59.31
then that will
minimize the cystitis problem.
00:15:59.35\00:16:02.65
In children often it is
due as it is in bedwetting
00:16:02.69\00:16:07.00
to food sensitivity,
these should be checked
00:16:07.03\00:16:11.21
and eliminated so you
first eliminate all the foods
00:16:11.25\00:16:15.49
that your going to test, and
when the cystitis has cleared up
00:16:15.52\00:16:20.09
the child no longer has the
problem, then you start adding
00:16:20.12\00:16:25.45
the foods back
one food at a time
00:16:25.48\00:16:27.52
until a food starts
making the problem again
00:16:27.55\00:16:30.37
and at that time
you start making a list.
00:16:30.40\00:16:33.38
Make a list of all
those foods that cause
00:16:33.42\00:16:36.37
the child to have the symptoms.
00:16:36.40\00:16:38.34
Now the symptoms of cystitis
are first urgency, and frequency
00:16:38.38\00:16:42.20
just like the little girl who
was not able to hold her urine
00:16:42.24\00:16:46.03
until she could get ready to
void, and would wet her clothing
00:16:46.06\00:16:50.03
That urgency is also
a hallmark of cystitis.
00:16:50.06\00:16:54.25
The urgency, the frequency,
sometimes they can't wait
00:16:54.29\00:16:58.40
more than ten
minutes between voiding,
00:16:58.43\00:17:01.24
and sometimes the
urgency is so great
00:17:01.27\00:17:03.86
that they are
unable to hold the urine
00:17:03.90\00:17:06.36
until they can
get prepared to void.
00:17:06.39\00:17:08.78
Another thing is pain,
pain or burning on urination
00:17:08.82\00:17:13.44
and if the pain is at the
beginning of the urination
00:17:13.48\00:17:18.03
then you suspect that it is the
lower part of the urinary tract
00:17:18.07\00:17:22.03
the urethra, and
the neck of the bladder.
00:17:22.06\00:17:25.54
But if the pain is at the end
of urination when the bladder
00:17:25.57\00:17:30.95
is contracting
doing its little toilette.
00:17:30.98\00:17:34.06
Which it should do all the
time, it should squeeze down
00:17:34.10\00:17:37.50
at the end of each urination,
and that squeezes off any debris
00:17:37.53\00:17:44.13
that may have accumulated
on the lining of the bladder
00:17:44.16\00:17:48.98
and helps that to be
passed from the body.
00:17:49.01\00:17:51.78
So that little
squeezing is a hygienic measure
00:17:51.82\00:17:54.56
on the part of the
bladder to keep itself clean.
00:17:54.60\00:17:57.46
If at that time, if
when the squeezing occurs
00:17:57.50\00:18:00.29
if that's the time of
the pain, then it means that
00:18:00.33\00:18:02.91
the problem is higher up, which
may be interstitial cystitis.
00:18:02.95\00:18:08.73
Now the interstitial cystitis
is certainly a big problem but
00:18:08.76\00:18:14.51
that's mainly in adults
and not the subject right now.
00:18:14.54\00:18:19.14
With children as you
find those foods to which
00:18:19.17\00:18:22.30
they are
sensitive, and remove them
00:18:22.33\00:18:23.78
often that's the end
of the problem for them.
00:18:23.82\00:18:26.59
Lack of proper water drinking
is a big issue with cystitis
00:18:26.63\00:18:31.71
so if your child frequently
has cystitis, then be certain
00:18:31.75\00:18:36.80
that they drink enough water.
00:18:36.83\00:18:37.80
How much water, well it's still
eight glasses, but it's just
00:18:37.81\00:18:41.82
eight child size glasses, so
a very small child has a little
00:18:41.86\00:18:45.85
glass, a bigger child
has a little bigger glass.
00:18:45.88\00:18:48.47
They can simply mark down every
time they have a glass of water
00:18:48.51\00:18:52.78
and by the time they've
gotten their eight glasses,
00:18:52.81\00:18:56.29
you know that they are finished.
00:18:56.32\00:18:58.39
So those two things getting
enough water, being certain that
00:18:58.43\00:19:03.00
there is no food, and of
course the infection matter
00:19:03.03\00:19:07.44
being very clean with the child,
that those can be very helpful.
00:19:07.48\00:19:10.88
Another thing that a lot
of people don't think about
00:19:10.91\00:19:14.27
is the use of soap.
00:19:14.30\00:19:15.93
Soap or bubble bath
those are very common causes
00:19:15.96\00:19:20.37
of having some kind of cystitis.
00:19:20.40\00:19:23.22
Wearing panties that
are not made of cotton,
00:19:23.26\00:19:29.25
that can also be a problem.
00:19:29.28\00:19:31.43
So armed with these bits of
information you should be able
00:19:31.47\00:19:35.95
to handle this
problem quite nicely.
00:19:35.98\00:19:38.51
Another thing that happens
in children, it's quite rare
00:19:38.54\00:19:42.89
but it might be of interest
to know that dehydration can
00:19:42.92\00:19:47.26
proceed to the
point that it can cause a
00:19:47.29\00:19:50.19
renal vein thrombosis.
00:19:50.22\00:19:52.10
If you allow the child to become
so dehydrated that the blood
00:19:52.14\00:19:59.26
pools in the veins
that drain the kidneys,
00:19:59.30\00:20:04.82
and return the
blood to the heart,
00:20:04.85\00:20:06.99
then a renal vein
thrombosis is certainly
00:20:07.02\00:20:10.48
a great threat to
the health of the child.
00:20:10.51\00:20:13.09
Fortunately
it's not very common,
00:20:13.13\00:20:16.66
but long before we have a child
00:20:16.70\00:20:19.20
capable of making a
thrombus in the renal veins
00:20:19.23\00:20:22.71
we should be
hydrating the child.
00:20:22.74\00:20:24.82
So if they cannot
keep fluid down by mouth,
00:20:24.86\00:20:28.34
if they cannot keep
fluid in because of diarrhea
00:20:28.38\00:20:30.81
then they still need
to have fluids taken.
00:20:30.84\00:20:34.23
At that point you need to
get professional assistance
00:20:34.27\00:20:38.24
and get some IV fluids.
00:20:38.27\00:20:40.25
Another thing that we
have in childhood is acute
00:20:40.29\00:20:45.51
glomerulonephritis, the
scene develops in this way.
00:20:45.54\00:20:50.73
The child has a
streptococcal sore throat,
00:20:50.76\00:20:53.04
or a streptococcal
infection somewhere else,
00:20:53.08\00:20:56.62
such as a boil or
elsewhere, an infected wound
00:20:56.66\00:21:00.66
and the streptococcus
does not cause the person to
00:21:00.69\00:21:04.76
the child to have the
glomerulonephritis directly
00:21:04.79\00:21:08.79
but a couple of weeks, following
the problem with the sore throat
00:21:08.83\00:21:15.35
or the streptococcal
infection, then the
00:21:15.38\00:21:19.69
glomerulonephritis occurs.
00:21:19.72\00:21:21.88
The first thing
that the parent may see,
00:21:21.92\00:21:27.21
may not be any
symptoms in the child.
00:21:27.24\00:21:30.18
They may just notice
that the urine is dark.
00:21:30.22\00:21:33.66
If this is a very small child
this can be seen on the diaper
00:21:33.70\00:21:38.04
but if it's an older child
it may be seen in the commode
00:21:38.07\00:21:42.38
when they have
passed their urine.
00:21:42.41\00:21:44.23
At that point some
investigation needs to be made
00:21:44.27\00:21:49.34
but they may have
pain, in the bladder,
00:21:49.37\00:21:52.59
or they may have pain in
the back, where the kidneys are.
00:21:52.63\00:21:55.60
Fever and chills may
also occur at that time,
00:21:55.63\00:21:59.36
and prostration so that
the child is by no means
00:21:59.39\00:22:03.09
well enough to be up an around.
00:22:03.12\00:22:05.33
Acute glomerulonephritis
is principally characterized
00:22:05.37\00:22:09.86
by blood, and by
albumin in the urine.
00:22:09.89\00:22:14.13
When the child's blood
pressure is taken, it is amazing
00:22:14.17\00:22:18.36
how high the blood pressure
00:22:18.40\00:22:19.82
can go under
these circumstances,
00:22:19.85\00:22:22.04
the reason for that, is that
an injured kidney from whatever
00:22:22.20\00:22:25.93
reason will release certain
hormones that tend to cause
00:22:25.96\00:22:30.69
a constriction of blood vessels.
00:22:30.72\00:22:33.64
Its not all the
blood vessels in the body,
00:22:33.68\00:22:35.55
but principally,
in fact specifically
00:22:35.58\00:22:39.05
the small blood
vessels of the body
00:22:39.08\00:22:42.71
which are mainly
composed of muscle.
00:22:42.75\00:22:46.31
Now if you will notice this
diagram that I'm going to draw
00:22:46.35\00:22:51.30
on the board, you will
see just what kind of artery
00:22:51.33\00:22:54.58
is involved with this.
00:22:54.61\00:22:56.00
It's an artery that's of
almost our smallest size.
00:22:56.04\00:23:02.32
They have the outside wall
there, and the inside lumen
00:23:02.36\00:23:08.66
is very small, and all of
this is muscle here, and so the
00:23:08.69\00:23:15.18
hormone from the kidney is
so strong, that it makes this
00:23:15.21\00:23:21.67
muscle contract.
00:23:21.70\00:23:23.58
As it gets tighter, then of
course the area for blood to be
00:23:23.61\00:23:28.92
in that small lumen diminishes,
and with the reduction in the
00:23:28.96\00:23:34.26
size of the lumen
of the blood vessel,
00:23:34.29\00:23:36.68
then the blood
pressure goes way up.
00:23:36.72\00:23:40.44
A child with
acute glomerulonephritis
00:23:40.47\00:23:45.58
may have a blood
pressure that's 350/180,
00:23:45.61\00:23:50.69
it can be enormously high.
00:23:50.72\00:23:53.07
The highest blood
pressures that we ever see,
00:23:53.11\00:23:55.32
Of course this must be treated
promptly so that the child
00:23:55.36\00:23:59.60
can resume normal activities.
00:23:59.63\00:24:03.34
Now acute glomerulonephritis
usually runs it course in about
00:24:03.38\00:24:07.23
a week or two
weeks, sometimes three.
00:24:07.26\00:24:10.76
We expect that recovery will
be complete, that there will be
00:24:10.80\00:24:15.53
no residual whatsoever
in the kidney, and the
00:24:15.56\00:24:19.08
kidney will function entirely
normal ever there after.
00:24:19.12\00:24:22.70
But approximately
10% of children with
00:24:22.73\00:24:26.48
acute glomerulonephritis
will proceed to chronic
00:24:26.52\00:24:30.43
or a sub-acute
glomerulonephritis
00:24:30.46\00:24:33.02
does not clear in the
usual few weeks that we expect
00:24:33.06\00:24:37.48
acute
glomerulonephritis to clear.
00:24:37.51\00:24:39.43
But will last a number of weeks
or a number of months longer,
00:24:39.47\00:24:44.12
with blood in the urine,
and protein in the urine,
00:24:44.15\00:24:48.56
so that the child may
still have some symptoms,
00:24:48.60\00:24:52.98
but usually the
symptoms are only the sign
00:24:53.01\00:24:56.66
of the blood or the
protein in the urine
00:24:56.69\00:24:59.95
May not be a lot of
blood, but may be enough
00:24:59.98\00:25:03.51
so that the parent
can see it in the commode
00:25:03.55\00:25:07.01
About 10% of those, that go
into that phase, will go into a
00:25:07.05\00:25:14.05
chronic phase, so you expect
more that 90%, maybe 95%,98%
00:25:14.08\00:25:21.05
of children with
acute glomerulonephritis
00:25:21.08\00:25:23.89
will clear up, but a
certain percentage will go on
00:25:23.93\00:25:27.54
to a chronic form of
glomerulonephritis, which is
00:25:27.57\00:25:31.03
progressive, and the
glomeruli, which are the
00:25:31.07\00:25:34.50
functioning units of the kidney.
00:25:34.53\00:25:37.38
They begin to constrict
and to scar down and die.
00:25:37.42\00:25:42.39
When the little
patient has lost enough
00:25:42.42\00:25:46.65
of the little
nephrons in the kidneys
00:25:46.68\00:25:49.79
then the kidneys
cease to function,
00:25:49.82\00:25:52.90
and we have a kidney failure.
00:25:52.93\00:25:55.41
In these children now we
have a capability of giving them
00:25:55.45\00:26:01.60
some very good relief by
getting a kidney for them,
00:26:01.63\00:26:06.24
and we can often relieve
their problem if they have
00:26:06.27\00:26:10.25
complete kidney
failure, by a kidney transplant.
00:26:10.29\00:26:14.24
This is a very
good treatment for them,
00:26:14.27\00:26:16.63
and they are
very good candidates,
00:26:16.66\00:26:18.71
they often do
quite well with that.
00:26:18.74\00:26:20.76
Another form of congenital
problem is that of polycystic
00:26:20.80\00:26:27.26
disease of the kidneys.
00:26:27.29\00:26:28.64
You may have heard
of this its not to rare.
00:26:28.68\00:26:32.05
You may know a person
who is in their 30's or 40's,
00:26:32.08\00:26:36.53
who has a kidney
problem, and if you inquire,
00:26:36.56\00:26:40.11
they tell you its
polycystic kidney.
00:26:40.14\00:26:42.38
What happens here is
that the connection between
00:26:42.42\00:26:46.10
the little glomerulus, and
the little tubule that drains
00:26:46.13\00:26:50.99
the urine produced in
the glomerular apparatus.
00:26:51.03\00:26:55.50
That little tube, they
do not match up exactly
00:26:55.53\00:26:59.93
in a lot of cases,
and what causes this
00:26:59.97\00:27:02.67
can be multitudinous.
00:27:02.71\00:27:04.52
It can be something in the
prenatal time when the mother
00:27:04.69\00:27:11.05
may have become intoxicated
with fumes, or with some kind of
00:27:11.08\00:27:17.41
food, or some other kind
of difficulty, or it may be
00:27:17.44\00:27:21.17
entirely a genetic problem.
00:27:21.20\00:27:23.77
At any rate, these cysts
began to grow, and by the time
00:27:23.81\00:27:28.15
the person is 40 to 50
they are really quite large,
00:27:28.19\00:27:32.74
and sometimes do induce
complete kidney failure.
00:27:32.78\00:27:37.26
Now we have not covered the
entire gamut of genitourinary
00:27:37.30\00:27:42.25
problems in children, but
we have covered a few of them
00:27:42.28\00:27:46.58
so that you can maybe under-
stand the importance of the
00:27:46.62\00:27:50.89
kidneys, and keeping
them in very good health.
00:27:50.92\00:27:53.28
May the Lord Bless you
with good health in this way.
00:27:53.32\00:27:56.56