One of our biggest concerns is to ensure that our children grow up healthy and happy. Despite all of our efforts, sometimes our children still get sick, and our worst fear would be for them to fall ill over serious injuries such as heart attack, kidney disease or even catching virus from influenza.
According to the University of Rochester Medical Center, kidney disease is short-term or permanent damage to kidneys resulting in loss of normal kidney function. There are a few causes of kidney failure, and that includes:
- birth defects
- hereditary diseases
- infection
- nephrotic syndrome
- systemic diseases
- trauma
- urine blockage or reflux
What to do If Your Child Has Kidney Disease?
We talked to Dr Yap Yok Chin, Consultant Paediatric Nephrologist (Managing Paediatric Transplant Patient since 2005), to get her input on the matter and what parents should know about this illness.
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What is the first thing you need to do if your child has kidney disease? How would the doctor evaluate them, and what treatment would they need?
A child with kidney disease should seek a specialist (Paediatrician/Paediatric Nephrology) for consultation on the type of kidney disease.
Before confirming the diagnosis, the evaluation process involves going through the medical history and a complete physical exam, including urine tests, blood tests, imaging studies, or a biopsy.
Among children with end-stage kidney disease in Malaysia, the leading causes of kidney disease are Glomerulonephritis and Focal segmental glomerulonephritis (include nephrotic syndrome) (39%), Congenital anomaly of kidney urinary tract (16%) (Reflux nephropathy, Obstructive uropathy, Renal dysplasia, Cystic kidney disease) and Systemic disease 4% (SLE & Metabolic)1.
Further evaluation and treatment for kidney disease in children depend on the cause of kidney disease.
2. Would chronic kidney disease limit their lifestyle, and they can’t live like other children?
Children with early stages of chronic kidney disease (1st to 2nd stage) might not have any symptoms and remain well to participate in all lifestyle activities.
Children with more severe kidney disease (3rd to 4th stage) and those undergoing dialysis will need dietary change - low salt and phosphate, take medicine to control blood pressure, proteinuria and anaemia.
From our experience, they may experience a negative self-image; however, they can still attend school as usual and light extracurricular activities.
3. Is it advisable for young children to go through kidney transplants?
Yes. Research has shown that children with a renal transplant have a better survival rate at 5 years (90%) than children on dialysis therapy (73-77%)1.
4. Would they need to follow a special diet?
Eating ideal food and at a proposition may improve the child’s growth. The child’s diet will need to be adjusted depending on the stage of chronic kidney disease and dialysis therapy.
Generally, I’d advise reducing the amount of salt (canned & processed/packaged food). Limit amount of phosphorus - dairy products, processed foods, packaged food and sodas. Keep in mind that the children will need adequate protein for growth.
5. What kind of medications do they need to take? How would it affect them?
Children may need to take medications to manage the symptoms and prevent complications such as anaemia, acidosis and control blood pressure. It’s important to discuss why your children need those medications with your health care professional and how it will affect them.
Common chronic kidney disease medications are:
- Blood pressure medication (Antihypertensive)
- Reduce the amount of protein in the urine (angiotensin-converting enzyme inhibitor or receptor blockade)
- Diuretics (Control of oedema)
- Phosphate binders (Prevent absorbing phosphorus from the food your children eat)
- Sodium bicarbonate (help to balance the acid in your child’s blood)
6. How is the recovery journey after the transplant?
The hospital recovering from a kidney transplant surgery is usually a week if there are no complications. Before going home, the transplant team will counsel the child and family on everything needed to know about taking excellent care of yourself and your new kidney.
During the first 3 months, there will be frequent bloodwork and reviews to monitor the child’s overall health and kidney function. During this period, it is crucial to keep the child’s hands clean, avoid crowded places, and take their medications as prescribed by the doctors.
7. Is the child able to live everyday life like everyone else after the surgery?
Your child will be able to return to school in 3 months after the transplant surgery. Make sure they exercise regularly. Avoid contact sports that can injure their belly area and adopt a healthy lifestyle.
Reference:
- Chapter 5, Paediatric Renal Replacement Therapy, Wong HS and BL Goh (Eds) Twenty Fourth Report of the Malaysian Dialysis and Transplant 2016, Kuala Lumpur 2018, www.msn.org.my
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