Why children can have kidney problem

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Why children can have kidney problem

Written by Sade Oguntola Tuesday, 16 March 2010

The kidneys play a critical role in the body by acting as the body’s filtering system, controlling water levels and eliminating waste through urine. Experts, however, caution that kidneys can fail in their duties both in children and adults, and so everyone needs kidney tests, at least, once in six months, reports Sade Oguntola.

A mother holding her sick baby She held the child close to her chest. The expression on her face was that of worry and fear after she was told that her baby could have developed kidney problem as a result of urinary tract infection (UTI). It sounded rather untrue that children, too, are susceptible to kidney problems, thought by many to be a problem for adults.

The kidneys play a vital role in the body. Acting as the body’s filtering system, they help to control water levels and get rid of wastes through urine.

They also produce three important hormones: erythropoietin, which stimulates the bone marrow to make red blood cells; renin, which helps to regulate blood pressure; and the active form of vitamin D, which helps to control the calcium balance in the body and maintain healthy bones.

If you are unconvinced that cases of kidney diseases in children are on the increase, it would be a worthy exercise to visit any tertiary hospital with experts on kidney diseases. One of such is the University College Hospital, where such cases abound. Their plight is so pathetic, as the parents need to pay N10, 000 weekly for dialysis, a medical procedure which helps to artificially expel waste products from their body system.

Kidney failure is less common in children than adults and is very different from kidney failure in adults. The most common causes of kidney failure in children are problems with the structure of the kidney, bladder, or anywhere along the urinary tract. Most children are born with these problems.

The signs and symptoms of urinary tract problems include fever, burning or pain during urination, recurrence of nighttime bedwetting (in kids who have been dry for several months) and difficulty in controlling urination in kids who are mature enough to use the toilet.

According to Dr. Adanse Asinobi, a paediatric expert on kidney problems at the University College Hospital ( UCH), Ibadan, Oyo State, the plight of children with kidney diseases is better imagined because the cost of dialysis is very expensive and kidney transplantation, which is the definitive treatment, is beyond the reach of many individuals.

“We offer dialysis to many children with kidney failure, but many of them cannot afford it, even though the UCH has been magnanimous to ask that they pay half the price of the cost of dialysis for adults. The adults pay N20,000 per session of dialysis while children pay N10,000. Even at that price, many of them cannot afford it. Financing has been a limiting factor and many have died.”

Kidney diseases and kidney failure are conditions, Dr. Asinobi declared, which sometimes have their origin in childhood.” Most diseases that manifest in adulthood have their origins in childhood, even while the baby is still inside the womb. This is why emphasis should be placed on prevention of chronic diseases, including chronic kidney diseases from childhood.”

Dr. Asinobi declared that African children are not too lucky with respect to kidney diseases because more African children develop kidney problems compared to Caucasians.”Unfortunately, many African children are dying without concrete diagnosis of kidney failure because the clinical features of kidney problems are just not the same, as you may have in malaria, general body weakness or aneamia. It is only when their urine, blood pressure and other kidney function tests are done that it would be found that the origin of the problem is from the kidney.

“Even when they have diseases like malaria, this can be complicated by acute kidney failure without people making that diagnosis. The problem is that unless such children are screened for kidney problem, you may not ascribe the symptoms to kidney disease,’’ he said.

The incidence of kidney problems is, however, worldwide. According to a new study, most sick newborns have kidney problem. In fact, a study in India found that as many as 70 per cent of sick newborn babies suffer from kidney dysfunction but less than five per cent of them get treated. The study was conducted over a period of 15 years on 300 sick newborn babies.

The study found that urinary tract infection (UTI) is a common cause of chronic kidney damage among children and adults. In addition, the study found that almost 6.5 per cent of girls and 3.3 per cent of boys below the age of one suffer from urinary tract infection.

Kidney damage in children can occur due to various reasons, which include problems within the urinary system and other factors like infections, hypertension, cancer, and multi-organ failure. Kidney stone disease in children is also not uncommon, with children below the age of five suffering the most.

According to Dr. Asinobi, chronic kidney diseases are on the increase globally among adults and children, including Nigeria. “It is estimated that kidney failure is more prevalent in sub-Saharan Africa, compared with the prevalence among the Caucasians. The sad thing is that Nigerians develop end-stage kidney failure much earlier than Caucasians. The age range quoted is between 20 and 50 in sub-Saharan Africa, whereas among Caucasians, it occurs above the age of 60 years.

She explained that cases of people with kidney failure account for a small fraction of people with kidney problem because it has with no external manifestations or any changes in the blood profile until it is too late.

Amazingly, Dr. Asinobi declared that “many people may die of stroke, hypertension, heart failure and it will be ascribed to the heart, even though the origin was initially from the kidneys. That is why we want to pick up such cases very early for appropriate intervention. We now know interventions measures to either stop the progression of chronic kidney disease or slow it down so that it does run a rapidly progressive course.”

She emphasised that chronic kidney disease is both common and treatable , stressing, “people must avail themselves of tests to assess the functions of their kidneys. If you allow a kidney problem to lead to kidney failure, it becomes very difficult to manage. In such cases, they would now require dialysis which is very expensive or kidney transplantation which costs about N7 million both for the surgery and maintenance costs.”

Dr. Asinobi stated that the fact that kidney failure was far cheaper than its treatment informed the decision of kidney experts from UCH as well as others from other parts of the world to always mark the World Kidney Day to raise awareness on kidney problems.

This year’s World Kidney Day celebration at the hospital afforded over 1,000 individuals the opportunity to enjoy free blood pressure, weight, height and urine tests to ascertain the health status of their kidneys.

On the occasion, Mrs. Titilola Olanite, a renal nurse, warned people to desist from indiscriminate use of pain medications, herbal medications as well as skin-toning creams. She stressed the need for regular blood pressure, blood sugar and urine tests at least once every six months, pointing out that hypertension was an indication of an impending health danger.