Kidney disease: advocating early detection

15Mar 2016
Our Reporter
The Guardian
Kidney disease: advocating early detection

In Tanzania, as the rest of the world, Kidney Week starts on the 10th of March and runs through to the 14th of every year. The 2016 campaign has a specific focus on kidney disease and children.

With 10% of the population worldwide having some form of kidney damage, there is a long road ahead to raise awareness about the dangers of kidney disease.

The latest numbers show that Chronic Kidney Disease (CKD) is predicted to increase by 17% over the next decade and is now recognised by WHO and other organisations as a global public health issue.

Kidney diseases affect millions of people worldwide, including many children. Some children are born with kidney disease and others develop it when still very young. The symptoms of kidney disease in children are often nonspecific, which means that there is a risk that kidney problems may be missed in children.

In childhood, the leading causes of kidney failure are hereditary conditions, often lacking obvious indicators such as hematuria (red blood cells in the urine), hypertension (high blood pressure) or edema (swelling). Additionally, kidney disease that becomes evident in adulthood may occur more often in persons with risk factors that can be detected in childhood.

This year, the focus is on the crucial need to encourage education, early detection and healthy life style to raise awareness of kidney diseases which affect millions of people worldwide, including children who are at risk of kidney disease at an early age.

“Pediatric Nephrology relates to kidney diseases in newborn and children up to 18 years age” explains Dr Mehul A. Shah, a Pediatric Nephrologist at Apollo hospitals. In a brief report released on occasion of the Kidney Week, the specialist notes that ‘Hyderabad Kidney Diseases’ in children can occur due to structural or developmental defects that happen during birth process.

They may also occur due to genetic factors meaning that it runs in the family or due to disturbances in environment that affect the immune system or also from medication. A number of these problems, if detected early, can prevent kidney damage.

Julie Ingelfinger, MD, Professor of Pediatrics at Harvard Medical School and Senior Consultant in Pediatric Nephrology at MassGeneral Hospital for Children, underlines the importance of CKD awareness and prevention from early age on; “It is important to be aware of and to detect pediatric kidney disease. Kidney disease can be treated, even in our smallest patients. Further, because much of adult kidney disease has its roots in childhood, it is critical to focus on infancy and childhood if we are to prevent and cure kidney diseases.”

Prevention better than cure

The preventive aspects of kidney problems include:

Urine test - Young children below 2 years of age who are suffering from unexplained high fever should be tested to rule out urine infection

Avoid holding of urine - Children who are more than 3 years age should be encouraged to pass urine in a relaxed manner every 2-3 hours during the day

Eating aspects – Children should be placed on daily fruits and vegetable diet

Reduce salt and red meat – Salt and red meats should be consumed moderately in the family's daily diet.

Exercise – Children should decrease TV or computer time and be encouraged on more outdoor activities to minimize excess weight gain

Avoid pain killers –Discourage consumption of pain killer medicines such as Nimesulide, Ayurvedic, Unani medicines and opt for Crocin, Calpol, and Paracetamol as much as possible to control fevers

Check blood pressure – This should be done at least once a year for every child beyond 3 years of age

For children suffering from anemia, high blood pressure, those who have blood in urine, body swelling or recurrent urine infections as well as those who are not growing well for kidney disease if the child is not growing well they should be tested for kidney disease, has anemia.

Kidney Disease and children, act early to prevent it
On March 10th, the world celebrated the 11th edition of World Kidney Day (WKD) with empahisis on how crucial it is to encourage and facilitate education, early detection and a healthy life style in children.
This should start at birth and continue through to old age to combat the increase of preventable kidney damage including acute kidney injury and chronic kidney disease and to treat children with inborn and acquired disorders of the kidney.
Kidney disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions.
Acute kidney disease (AKI) is a serious condition that develops suddenly, often lasts a short time and may disappear completely once the underlying cause has been treated and if the patient receives the needed medical management, but it can also have long-lasting consequences with life-long problems.
Chronic kidney disease (CKD) doesn’t disappear with treatment and tends to worsen over time. CKD eventually leads to kidney failure (end-stage kidney disease) and needs to be treated with a kidney transplant or blood-filtering treatments (dialysis) for life.

Acute Kidney Injury or AKI
An example of AKI is hemolytic uremic syndrome, or HUS. This is a kidney condition that develops when red blood cells are destroyed and block the kidneys’ filtering system. When the kidneys and glomeruli—the tiny units within the kidneys where blood is filtered—become clogged with the damaged red blood cells, they are unable to do their job. If the kidneys stop functioning, a child can develop acute kidney injury—the sudden and temporary loss of kidney function. Hemolytic uremic syndrome is a common cause of AKI in children.
Another cause of AKI, including children, is trauma such as burns, dehydration, bleeding, injury or surgery. Trauma can cause very low blood pressure, which in turn can result in insufficient blood supply to the kidneys leading to acute kidney failure.

Chronic Kidney Disease or CKD
CKD in children can be caused by birth defects (e.g. children born with only one kidney or with kidneys with abnormal structures), hereditary diseases (e.g. polycystic kidney disease), infection, nephrotic syndrome (a collection of symptoms with loss of protein in urine and water and salt retention in the body that indicate kidney damage), systemic diseases (involving many organs of the body including the kidneys, such as Lupus), urine blockage or reflux (e.g. problems of the urinary tract and bladder).
From birth to age 4, birth defects and hereditary diseases are the leading causes of kidney failure. Between ages 5 and 14, kidney failure is most commonly caused by hereditary diseases, nephrotic syndrome, and systemic diseases. Between ages 15 and 19, diseases that affect the glomeruli are the leading cause of kidney failure.
Children’s kidney diseases are kidney diseases for life. The majority of children with kidney disease progress to end-stage kidney diseases in adulthood.