Page 323 - Abstract Book KONIKA 18

Nephrology

P-NEP-009
Nephrolithiasis in A 3-year-old Boy: A Case Report

Ni Putu Ayu Elistya Ning Purwani, A. A. Made Sucipta
Department of Child Health, Wangaya Hospital, Denpasar, Bali, Indonesia
Abstract
Background The incidence of nephrolithiasis in children has increased sharply in the last two decades.
Children with nephrolithiasis are at risk of recurrence and an increased risk of chronic kidney disease.
Objective To find out the description of pediatric patients with nephrolithiasis. Case Three years 6 months
old boy had a complaint of bloody urine since a month ago. There was a white sand-like precipitate when he
urinated. There were no complaints of abdominal pain, nausea, vomiting or fever. Pain on left costovertebral
angle (CVA) was not found. Laboratory finding showed positive erythrocyte in urinalysis. ultrasonography
and abdominal CT-scan consistent with nephrolithiasis in left kidney. The patient was planned for Mini
PCNL (Percutaneous Nephrolithotomy) by a urologist. Postoperative stone analysis was performed to find
ammonium urate (68%), uric acid (11%) and 2.8 dihydroxyadenine (15%). He was given D5NS 16 drops
per minute, paracetamol 4 x 200 mg IV, cefotaxime injection 3 x 500 mg and tranexamic acid 3 x 150 mg
IV. Conclusion Nephrolithiasis is a disease in children that can occur due to several risk factors such as
nutritional intake, environment, genetics and lifestyle. This disease needs a precise diagnostic and adequate
therapy for prevent its complication.

Keywords: nephrolithiasis; pediatric; risk factor; uric stone

P-NEP-010
A 14-year-old Boy with Nephrotic Syndrome et causa Glomerulonephritis Acute
Post-streptococcal: A Case Report
Evan Christian Oetama, Sri Wahyuni Djoko
Departement of Child Health, Faculty of Medicine Universitas Pattimura, Bhayangkara Hospital,
Ambon, Mollucas, Indonesia
Abstract
Background Nephrotic syndrome is characterized by edema, massive proteinuria, hypoalbuminemia, and
hyperlipidemia. Nephrotic syndrome ec glomerulonephritis acute poststreptococcal with extensive damage
over 6 years of age has rarely reported. Objective To demonstrate favorable response of intial steroid
therapy in Nephrotic syndrome ec glomerulonephritis acute poststreptococcal clinical. Case A 14-year-old
boys came with breathless, edema lower extrimities, edema scrotum, edema face and orange pee. Physical
Examination edema face like a balloon, decreased sounds lungs, abdomen distention, ascites, shiffing dulness
(+), undulation (+), knocking pain (+), edema scrotum the size of a tennis ball with hyperemic, edema lower
extrimities. The results of laboratory examination are proteinuria (+3), leucocyturia, haematuria, glucose
(+3), uremia, increasing of creatinine, hypoalbuminemia, hypercholesterolemia, anemia, leucocytosis, and
thrombocytosis. Based on this data, the patient was diagnosed as nephrotic syndrome and the differential
diagnosis was acute nephritis. For further examination, it is suggested urine protein quantitative, anti
streptolysin O, and complement C3. Radiology examination chest X-Ray showed pleural effusion bilateral
and ascites abdomen. Patient got steroid therapy (intial therapy) during 6 weeks in hospital condition
improved but patient complain pain in waist. We have to evaluate the kidney condition of the patient.
Conclusion Nephrotic syndrome ec glomerulonephritis acute poststreptococcal has rare manifestation.
Intial steroid therapy getting improved but must evaluation kidney, therapy to prevent resistant and relapse.

Keywords: nephrotic syndrome; glomerulonephritis acute; streptococcal infection; children

KONIKA XVIII Abstract Book 275