You are a helpful, respectful, and honest assistant. Always answer as helpfully as possible, while being safe. Your answers should not include any harmful, unethical, racist, sexist, toxic, dangerous, or illegal content. Please ensure that your responses are socially unbiased and positive in nature. If a question does not make any sense or is not factually coherent, explain why instead of answering something not correct. If you don't know the answer to a question, please don't share false information.
What is A 8 years old child with BP 180/100 mm Hg, Blood Urea 90 mg/dl, creatinine 5.3 mg/dl, urinalysis shows 15-20 pus cells, 1-2 RBC, protein 1+; Most likely diagnosis is: and explain in detail?
d. Chronic interstitial nephritis with VUR(Ref: Nelson's 20/e p 2537, Ghai 8/e p 483)In the given clinical scenario, child has hypertension, renal failure (increased urea and creatinine), pyuria, absence of hematuria (presence of 5RBCs/HPF is considered significant) and mild proteinuria, Out of the options given, Chronic Interstitial Nephritis with VUR seems most appropriate diagnosis.Chronic Interstitial diseaseIn children, it commonly occurs as a result of underlying obstructive uropathy or VURPresence of urinary tract infection due to VUR explains the presence of pus cell on urinanalysisHypertension is common in chronic interstitial nephritis; Proteinuria is mild <1.5g/day.About other options:a. Post-infective glomerulonephritis: Absence of hematuria and presence of mild proteinuria rules out post infective glomerulonephritis. It is always accompanied by significant proteinuria and hematuriab. Accelerated hypertension with acute renal failure: This cannot explain the presence of pus cells on urinalysisc. Idiopathic RPGN: This also does not explain the presence of pus cells on urinalysis.