Categories: Nephrology

Kidney disease in children

What are the common symptoms of kidney disease?

If you see any of these symptoms in your child, arrange a visit with your Paediatric nephrologist and get your child checked.

  • Swelling of body
  • Decreased appetite or lack of appetite at all
  • Stunted growth compared to a peer group
  • Increased or decreased urination frequency
  • Wetting the bed, foamy, dark or red urine
  • High blood pressure
  • Pale skin, bad breath or hearing problems
  • Bone pain or deformity of bone
  • Poor performance in school

Facts about kidney disease:

About 10% of the population worldwide is affected by chronic kidney disease, and millions die each year because they do not have access to appropriate treatment. Only 10% are fortunate to get treatment. Many people cannot afford treatment at all, resulting in the death of over one million people annually from untreated kidney failure. Diarrhea and Sepsis is a common cause of death among children in India. For survivors, the diarrheal disease can also result in acute kidney injury. Low birth weight infants are at a greater risk of being born with small kidneys. These babies are more likely to develop significant elevations in blood pressure and high risk to develop chronic kidney disease.

What are the causes of kidney disease in children?

Kidney disease in children is complicated and sometimes results from multiple medical conditions and can cause serious health issues. Common causes are:

  • Prematurity
  • Birth defects
  • Hereditary diseases
  • An infection like diarrhea, pneumonia, UTI
  • Nephrotic syndrome
  • Systemic diseases
  • Trauma & drugs
  • Urine blockage or reflux

Who are at risk for kidney disease?

The risk for acute kidney disease which starts suddenly:

  • Blood loss, surgery, or shock
  • A blockage in the urinary tract
  • Been taking medicines that may cause kidney problems
  • A condition that may slow or block oxygen and blood to the kidneys, such as cardiac arrest
  • Haemolytic uremic syndrome
  • Glomerulonephritis

The risk for chronic kidney disease which gets worse slowly over at least 3 months:

  • A long-term blockage in the urinary tract
  • Recurrent urinary tract infection
  • Alport syndrome
  • Nephrotic syndrome
  • Polycystic kidney disease
  • Cystinosis
  • Untreated diabetes
  • Untreated high blood pressure
  • Untreated acute kidney disease

How to prevent it?

There are many simple screening tests available such as ultrasound and urine dipsticks that can detect kidney and bladder abnormalities either before or shortly after birth and better provision of treatment to slow or stop the progression of kidney problems.

A healthy lifestyle like increased fluid intake, exercise, regular health check-up, control of high blood pressure, high blood sugar, avoidance of junk food or drinks contain sugar, caffeine helps to prevent kidney disease.

Why Paediatric nephrologist?

Renal management in children is different than adults, not only owing to their small size but also the nature of their illnesses are a lot different than adults. Children are not just small adults. Their bodies are growing and have unique medical needs. They usually express their concerns differently than adults do. They cannot always answer medical questions and are not always able to be patient and co-operative. Paediatric nephrologists know how to examine and treat children in ways that help them relax and co-operate. In addition, Paediatric nephrologists use medical equipment designed just for children. It requires special expertise to recognize the disorders early and institute management as most of these can be well controlled to provide the patient an otherwise normal life.

The burden of renal diseases especially chronic renal failure in India is increasing every year. The number of children requiring dialysis and renal transplant is on a rise owing to not only the lack of availability of donors but also their tiny size precludes many nephrologists to care for them. Most of the Adult nephrologists are either not trained to or are unable to create access for their dialysis, and many times the manpower is not trained enough to handle children. It is important that people are specially trained in this area to recognize and handle these problems and provide them utmost guidance and highly specialized care for them.

What do we do?

As Paediatric nephrologists, we diagnose, treat, and manage many disorders affecting the kidney and urinary tract, including kidney failure, high blood pressure, inherited kidney diseases, kidney stones, urinary tract infections, and abnormalities in the urine such as blood and protein (Nephrotic Syndrome). We provide services like dialysis, kidney transplant, kidney biopsy.

We are the co-ordinators of a team that includes specialized nurses, dieticians, and social workers, all dedicated to the care of children with kidney diseases. We also work closely with other physicians such as Paediatric urologists, Paediatric surgeons, and Paediatric radiologists.

If your Paediatrician suggests that your child should see a Paediatric nephrologist, then you can be assured that your child will receive the best possible medical care.

Dr. Subhankar Sarkar, Consultant Nephrology – Paediatric, Narayana Multispeciality Hospital, Howrah

Narayana Health

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