Kidney Disease and Children

“For in every adult there dwells the child that was, and in every child there lies the adult that will be.” John Connolly, The Book of Lost Things

Kidney disease in children presents in a subtle manner and is often detected late in young adults. Hence it is important to pick it early before they progress to a stage of no return. Kidney disease in young adults that seems to suddenly strike in young adults often has its roots in childhood.

Kidney Disease In Children:

Kidney disease in children can present as an acute condition with complete reversal of functions or may have long lasting consequences eventually leading to kidney failure. Kidney disease in children can be caused by congenital anomalies of kidney and urinary tract, genetic abnormalities, infections, nephrotic syndrome, autoimmune conditions, trauma or obstruction in urinary tract. Below 5 years, hereditary causes are most common causes of kidney injury while above 5 years acquired causes are more common.

Obesity is the biggest reason :

Obesity is a potent risk factor for the development of kidney disease. Obesity is one of the strongest risk factors for new-onset chronic kidney disease, and also for nephrolithiasis and for kidney cancer. India is third most obese nation in the world. In India over 15 million children are currently estimated to be overweight. Latest estimates show prevalence of obesity in India among adolescents (13-18 years) has grown from 16% to 29% over the last five years. there is 70% chance of an obese adolescent to become obese adult. Hence it is important to instill healthy lifestyle in children to prevent diabetes stroke when they become adults.

This year world kidney day theme is Kidney disease and Obesity emphasizing the importance of healthy eating habits and healthy lifestyle.

Important steps for preventing CKD during ante natal period:

• Vaccination for rubella
• Screening and treatment for cytomegalovirus and toxoplasmosis
• Avoid ACE inhibitors and NSAIDs
• Opt for antenatal ultrasonography

Importance of screening for CKD during Post Natal Period :

• Screening for proteinuria and hypertension in children with birth defects and hereditary diseases
• Follow up of LBW babies, acute kidney injury
• Keep weight in check
• Avoid nephrotoxic medications and prompt fluid therapy in patients with dehydration