Eternal vigilance over our kids’ health

The second Thursday of March of every year is celebrated the world over as the World Kidney Day. It is a day specially dedicated to promote the importance of the kidneys and reducing the frequency and impact of kidney disease and its associated health problems worldwide. The Day carries a lot of fanfare the world over, but unlike what happens in Europe and North America, many of us in Nigeria and other developing countries get carried away in the fanfare and lose the opportunity the Day affords us to critically assess our situation and formulate necessary policies that will assist us in achieving better kidney health for their citizens.

This year, the date for the celebration is 10 March and the theme of the celebration is Kidney Disease & Children. Act Early to Prevent It! This theme underscores the rising prevalence of kidney diseases in children. It also drives home the need for regular checks in order to detect the onset of kidney-related issues early.

Kidney diseases in children, as in adults, are categorized into acute kidney disease and chronic kidney disease to reflect their response to treatment. Acute kidney disease is a serious medical condition that could easily go away once the underlying causes have been treated. It could also have long-lasting effects. Chronic kidney disorders, on the other hand, do not go away with treatment but tend to worsen over time and may lead to kidney failure.

Acute kidney disease could be caused by hemolytic uremic syndrome; a condition that occurs when the kidney’s filtering system is blocked by the red blood cells that have been destroyed. It could also be caused by insufficient blood supply to the kidneys as a result of trauma – burns, injury, bleeding, surgery and dehydration.

Chronic kidney diseases are caused by a number of factors, ranging from birth defects to heredity, infection, systemic diseases, reflux etc. Some children are born with renal agenesis (only one kidney), renal dysplasia (where only one of the two kidneys is functional) or ectopic kidney (a kidney that is located below, above, or on the opposite side of its usual position). Experience has shown that while these birth defects expose these children to increase risk of developing kidney diseases, especially in their zero to four years of life, most of the children with these conditions lead full and healthy lives.

While some children inherit some diseases like the polycystic kidney disease, others acquired kidney diseases through infections, urine blockage due to problems with the urinary tract or bladder, issues from the other organs of the body etc. irrespective of the nature of the kidney disease, the reality is that there is increase in the prevalence of kidney diseases in children and this should give us all a bit of a worry for two predictable reasons – the near-unavailability of care centers and the abominable cost of managing the disease condition.

In the whole of Nigeria, we have less than 100 dialysis units and less than 15 renal transplant units to cater for the approximately 100,000 persons that are living with kidney disease conditions in the country. On management of renal failure, a patient would have to choose between kidney transplant and dialysis. If he opts for hemodialysis, he will have to undergo three sessions every week at a cost of N30,000 per session. This amounts to N4.6 million annually, and of course, excludes cost of medication. If he opts for a transplant, he would have to pay up to N10 million for the procedure and will subsequently be spending up to N200,000 monthly on medication for life. These costs are predicated on a smooth procedure that does not have complications. It also excludes the effects of the treatment on the person’s physical, mental and psychological wellbeing. These treatments have many serious and, sometimes fatal, adverse effects, especially for children. Lastly, coping with managing renal failures brings huge physical, financial and psychosocial strain to the family. It is not a thing one wishes, even for his enemies.

The most enlivening things about kidney diseases are that they are more easily managed and costs almost next-to-nothing when detected early than when the disease is fully developed. The icing on the cake with early detection is that it may only require no more than change in lifestyle and regular checks to reverse impending kidney issue. Again, the major factors that cause chronic kidney diseases are diabetes and hypertension which could be detected by measuring blood pressure and blood sugar. Also like the chronic kidney diseases, acute kidney diseases, especially in children could also be detected with urine and blood tests and biopsy.

We could start with running the basic tests of urinalysis, blood sugar, and body-mass index (BMI) on ourselves and our children in reputable pathological centres irrespective of their ages and share the results with our doctors who will advise us on next steps. We may have to review our dietary servings to our children and, if need be, reduce their sugar consumption. Most of us include fizzy drinks (soft drinks and packaged juices) and highly sugary biscuits in their lunch boxes daily. This act is far from unhealthy as it may shoot up their blood sugar and make them prone to diabetes and obesity – two major factors that lead to kidney diseases.

So as we mark this year’s World Kidney Day, let us join forces to inform parents, caregivers, young patients, policy makers and the general public of the importance of identifying and treating childhood kidney diseases, instilling an awareness of the risks for their future from kidney damage that originates in childhood, therefore building healthier future generations!

Dr. Olusanya, a Consultant Clinical Virologist and infectious Disease Physician with PathCare Laboratories, wrote from Lagos and could be reached on olawaleo@path carenigeria.com