World Kidney Day 2016: Act early to prevent renal diseases in children

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This World Kidney Day, WHO has adopted the theme 'Act early to prevent it' to highlight the rising numbers of renal diseases in children across the globe. Here's what you should watch out for to identify renal problems in kids

Each year, about 17 out of 100 urban Indians suffer from kidney diseases. Of this number, six percent have stage III kidney diseases, which necessitate medical intervention and in many cases dialysis. Many of these urban sufferers are sadly young children.

These figures were shared in a 12-city Screening and Early Evaluation of Kidney Disease (SEEK) study, which collected data from 13 government and private hospitals. It also found that while 64.5 percent of surveyed persons who suffered from chronic kidney diseases (CKD) also had hypertension, 4.7 percent had anemia and 31.6 percent also had diabetes.

Experts suggest that these escalated numbers also reflect urban lifestyle and its affect on young persons and children.

Globally, about 10 percent of the worldwide population is affected by CKD, and in keeping with these numbers, this year the World Health Organisation (WHO) decided to have 'Kidney Disease & Children: Act early to prevent it!' as its primary theme for World Kidney Day 2016.  

Common childhood renal diseases

These alarming numbers have made it critical for urban parents to understand the various renal diseases in children. We spoke to Dr Sonia Sharma, consultant pediatric nephrologist, PSRI Hospital, New Delhi, for the same.

1. Urinary tract infections (UTI): They are easy to diagnose in older children and adults, but difficult in infants with vague symptoms.

Symptoms: You can keep a tab on symptoms including frequent, painful, burning urination; fever and urine may appear cloudy or bloody. If infection reaches the kidneys, back pain and high-grade fever may follow.

Treatment: For UTI, a urine sample is taken to check for bacterial growth. "If the child is given antibiotics, relief usually begins within 12 to 24 hours. If the UTI affects the kidneys, hospitalisation and intravenous medications are usually required," she says.

2. Nephrotic Syndrome: This is characterised by the persistence of low albumin and high cholesterol levels in the blood and documentation of high urinary protein. "Although the most commonly affected age group is 3-4 year, we often see kids beyond this age group that suffer from it. Age of onset also determines the severity and response to treatment. If it presents in infant of less than three months of age (congenital nephrotic syndrome), no treatment is advised other than support with albumin transfusion and diuretic treatment whenever required," says Dr Sharma.

Symptoms: If your child has a sudden onset of swelling over face, eyes and body and has significant urinary protein, it is a symptom of nephrotic syndrome. It can appear with or without upper respiratory tract infection symptoms.

Treatment: Congenital nephrotic syndrome is often associated with genetic mutation. For Nephrotic syndrome, beyond the age group of 3-4 years, oral steroids are the main stay of treatment, which are prescribed after documenting no hidden underlying infections. Dr Sharma adds, "When a person does show response to steroid therapy, then kidney biopsy is needed which should be done by pediatric nephrologist."

She also adds that parental support and counseling is also very important. "A child suffering from this problem, needs to take prescribed medicine regularly as per the treatment advised. He also needs to maintain a diary for regular urine protein monitoring at home," she says.

3. Acute kidney disease (AKI): In this disease, a person's kidney may suddenly stop working due to drop of blood flow in kidney or reaction to medication. It may develop suddenly and lasts a short time, or can be serious with long-lasting consequences or may go away completely once the underlying cause has been treated. Acute kidney disease may require dialysis therapy for short duration.

Symptoms: The common symptoms are little or no urine, swelling in the legs and feet, nausea or vomiting, feeling anxious or confused and pain in the lower back of the ribcage.

Treatment: The treatment for acute kidney diseases begins with restoring the blood flow in the kidney or even bypass of the urinary tract.

4. Chronic kidney disease (CKD): It does not go away with treatment and tends to get worse over time. "CKD leads to kidney failure, which is treated with a kidney, transplant or blood-filtering treatments called dialysis," says Dr Sharma.

Symptoms: The common symptoms are a loss of appetite, general feeling of fatigue and illness, nausea, weight loss and skin itching.

Treatment: Childhood dialysis and transplant can be done with pediatric nephrologist, who takes care of all aspect related with the disease. Dr Sharma adds, "Children with CKD or kidney failure face many challenges and need great family support to avoid a negative self-image, behavior problems, learning problems. It can trouble child in concentrating, delayed language skills development and delayed motor skills development. Children with CKD may grow at a slower rate than their peers."

Continue reading to read more about common kidney diseases' symptoms.

Common kidney diseases symptoms

Here are some symptoms of a kidney disorder that parents must be wary of:

  • Swelling around the eyes, face, feet, abdomen or the whole body
  • Bedwetting (five years or older) since birth or if the problem reoccurs after the child had stopped bedwetting
  • Frequent urination
  • Crying during urination (in infants)
  • Painful urination (in older kids)
  • Unpleasant-smelling urine
  • Unexplained low-grade fever or recurrent fever episodes
  • Urine that is cloudy, bloody or dark brown
  • Persistent abdominal pain
  • Childhood renal stones
  • Frequent severe headaches
  • High blood pressure
  • Oliguria with diarrhea (producing less urine)
  • Polyuria (producing more than 2 litre urine/day)
  • Poor appetite (in older children)
  • Poor eating habits, vomiting (in newborns & infants)
  • Slow growth or weight gain
  • Weak urinary stream, dribbling of urine stream
  • Weakness, excessive tiredness or loss of energy
  • Pale skin appearance

If you spot any of the aforementioned symptoms, Dr Sharma recommends that you should introduce a healthy lifestyle in children.

Healthy lifestyle in children to prevent kidney diseases

  • Good intake of water is suggested to the children for proper functioning of kidney.
  • Salt should be included in a normal or low amount.
  • Protein intake should be in adequate amount. Taking more protein is not suggested.
  • If there is a family history of stone, then children should also be screened for its detection.

If someone is already suffering from ACD or CKD, the following precautions must be taken.

Things to avoid in daily diet:

  • Canned or packed fruit juices that have high level of potassium in them.
  • Apples
  • Mangoes
  • Grapes
  • Bananas
  • Oily foods that can increase the level of cholesterol.

Things that should be included in daily diet:

  • Strawberries
  • Blueberries
  • Watermelon

The most basic form of treatment to prevent all renal diseases is maintenance of healthy lifestyle. If you include nutritious foods in your child's daily diet and encourage detoxification, you will help keep kidney diseases at bay.

(Image courtesy: Netdoctor)

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Written by

Deepshikha Punj

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