National Hospital, Abuja, Dr. Seyi Oniyangi, discusses issues related
to the kidney failure in children
Whatis kidney failure?
Kidney failure is when the kidney cannot perform its normal functions
which include producing urine. At this stage, we say the kidney has
failed. It also means it can no longer remove waste products from the
body through urine. Someone with kidney failure is forced to retain
waste products in the body.
What causes kidney failure?
There are many things that cause failure. However, some of the most
common causes, in adults include hypertension – this is one of the
major causes, it is called a silent killer. It damages the kidney,
liver, heart and many other organs. It is one of the major causes of
kidney failure. Another major case is diabetes; this is when there is
too much sugar in the body. Then, too much fat. Too much fat prevents
blood from flowing well, through blood vessels. This also damages the
kidney. Infection, is another cause, taking over-the-counter drugs too
causes kidney failure. Sometimes, even drugs prescribed in the
hospital can cause kidney failure; a good example is gentamicin
injection. This drug is easily available, but if not used properly can
cause kidney disease. There are also drugs in bleaching creams that
trigger kidney failure.
Who are the people susceptible to kidney failure?
There are two groups of people that are likely to have kidney failure;
sickle cell and HIV positive persons. Over time, HIV persons are now
living longer and a large percentage of them end up developing kidney
disease.
Do children also have kidney problems?
Yes, they do.
What causes kidney failure in children?
The commonest cause of kidney failure in children is infection. When a
child has urinary tract infection- this infection affects the kidney
and the urinary tract. Some of these infections are silent in children
and don't show the symptoms we see in adults, so it's easy to treat
inappropriately. This infection then damages the kidney. Another thing
that can causes, kidney failure in children is inappropriate use of
drugs. We also have children that are born with abnormalities in their
kidney, as they grow older, the abnormality manifests and eventually
leads to kidney failure. There are also children who developed kidney
disease after they were born. These children will include those with
infection in the throat or skin. The kidney may overact to this
infection and cause nephritic syndrome. Nephritic syndrome is one
causes of kidney failure. Another thing is glomerulo nephrithis. This
is when there is a swelling of the kidney following infections,
toxins, drugs given to the child. This can lead to the child having
kidney failure. These are the common causes of kidney failure in
children.
Can people with acute kidney problem recover from it?
It all depends on the cause of acute kidney injury and the extent of
acute kidney injury. It is difficult to tell how long they would take
to recover. However, most people recover when are properly treated.
But there are some people who, after they have recovered, may develop
chronic kidney disease and end up with kidney failure in the long
term. However, this is not the case for children, it has been observed
that children recover better than adults.
What at the symptoms of kidney failure?
The commonest sign is swelling of the body because the person is
unable pass out urine. The body ends up retaining water and other
waste products which should have been passed out. Another symptom is
the swelling of the face and feet. These symptoms get worse as the
kidney degenerates. The person also feels tired and weak because of
shortage of blood. The person may also experience headache, abdominal
pain, difficulty in passing urine, however; the signs are different in
victims.
How can kidney failure be prevented?
For adults, they must live a healthy lifestyle; they must develop this
habit early. Hypertension, diabetes, excessive fat can be controlled
by healthy living. They should eat a balanced diet on a daily basis,
avoid too much protein, carbohydrate and eat little fat. We also need
to drink a lot of water because the more we drink water, the more the
kidney flushes out waste. We should also learn to take walks.
Nigerians have become lazy; very few of us take walks. We should
exercise on a daily basis. This should become a habit. We should also
do regular health checks. These health checks are needed to detect
diseases such as diabetes mellitus. Buying drugs off the counter
should also be avoided while women too should avoid bleaching their
skin. This is one of the causes for kidney failure. People should also
know their HIV status. People with HIV may not be aware, and they will
have the virus in their body 10 to 15 years. By the time they realise
it, their kidney might have been damaged.In children, we can prevent
kidney failure, by undergoing frequent antenatal care for our pregnant
mothers. Ultra sound is another useful way to detect if one's child
would have an abnormality with their kidney. We should also treat
infections properly. Constantly check your child's urine to ensure
they don't have any infection. Parents should also teach their
girl-child how to clean themselves after toilet use. It should be done
from the front to the back. These are just a few ways to prevent
kidney failure in children.
However, early diagnosis is key. For example, an abnormality of the
kidney system may make boys urinate in drips. If this happens, it
means the affected child has an abnormality which can be fixed early,
but if not corrected surgically, the kidney will be damaged and the
child may have kidney failure. Prompt treatment of infection and not
abusing drugs reduce the chances of a child developing kidney failure.
What is dialysis and what are the various types?
It is the process where waste products are removed from the body
because the kidney can't do so. There are two types; the first is
chemo dialysis- waste products are removed through the blood. Blood is
taken out of the person and passed through a machine that then removes
waste products. After which the blood is put back into the person.
This is more easily available in Nigeria. Another type is Peretoneal
dialysis- fluid is inputted into the abdomen of the person and then
the person carries this fluid for some time. During the process of
carrying the fluid, waste products accumulate in the fluid and then
the fluid is drained out and the cycle is repeated.
How long can one be on dialysis?
There are people who have been on dialysis for 10 years or longer. But
dialysis is meant to be short.
How long will someone with chronic kidney failure continue with dialysis?
It depends on the cause and severity of kidney failure. However,
dialysis is in stages. By the time the person reaches stage five, they
will need a transplant.
What dietary change does someone who is undergoing treatment need to implement?
A good diet is important. The person needs very little salt, because
their body now retains fluid. Then normal protein, not too much
protein, very little oil is needed in the person's diet. In addition,
there is a substance in the body called potassium, if it is too much,
it causes heart failure. Sources of potassium include apple, banana
and potassium used in soups.
Is anaemia related to kidney disease?
Yes, there is a hormone produced by the kidney which is necessary to
make red blood cells. But when there is kidney failure, it produces
this hormone in little quantity and zero amount later on which causes
anaemia.
How is kidney disease diagnosed?
There is a process, the doctor listens to the person and examines the
person. There are screening tests for kidney disease. Among these is
urine analysis.
How can we keep the kidneys healthy?
Water is important; it makes the body produce urine fast unlike soft
drinks. Regular check-ups, healthy lifestyle, and avoidance of drugs
are all necessary ways to keep the kidneys healthy.
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