Kidney diseases are silent killers, which largely affect the quality of life. Sadly, the warning signs are missed early on and are detected when patients reach end stage kidney failure or when a major portion of the kidney gets damaged. Going with this year’s theme of World Kidney Day (March 10) focusing on kidney ailments amongst children, a city-based hospital conducted a survey of 503 children from government schools at urban and semi-urban areas of the city and found that 5% of children had asymptomatic renal diseases.
In a bid to make children and their caretakers aware of kidney diseases, BGS Global Hospital conducted a survey last week among 503 children from three government schools. “Of the 503 children screened, we found 25-27 children with renal abnormalities. Overall, 5% of children were found to have asymptomatic renal disease by urinalysis with prevalence of proteinuria, microscopic haematuria and pyuria. One was detected to have diabetes. These children will have to further undergo evaluation at the hospital,” said Dr Anil Kumar, Consultant Nephrology and Kidney transplant, BGS Global Hospital.
“We know that India is the diabetic capital of the world and both diabetes and hypertension is also increasing alarmingly, and so is juvenile diabetes. Acting early and diagnosing early can go a long way in taking charge and preventing the disease from occurring,” said Dr Venkatramanna N.K., vice-chairman, BGS Global Hospital.
“In our unit, we have conducted approximately 20 paediatric kidney transplants in the last ten years. Recently we also did three free paediatric transplants as part of the announcement made in the last World Kidney Day,” said Dr Sudarshan Ballal, Chairman Manipal Hospitals.
“It is important to be aware and to detect paediatric kidney diseases. Because much of adult kidney diseases have their roots in childhood, it is critical to focus on infancy and childhood if we are to prevent and cure kidney diseases. Dialysis and kidney transplant patients are surviving longer due to advancements in medicines. But rates of end-stage kidney disease continue to rise,” said Dr Anil Kumar, Consultant, Nephrology and Kidney Transplantation, BGS Global Hospital.
Dr Vishwanath Siddini, HoD & Consultant, Paediatric Nephrologist, Manipal Hospitals, said, “In recent times, there has been a sharp growth in the number of people suffering from kidney-related diseases. It is important to make the general public aware of kidney diseases that affect millions of people worldwide. Many children too may be at risk of kidney diseases. It is crucial to encourage early detection and instil healthy lifestyle among children, starting at birth and continuing through to old age, to combat the increase of preventable kidney damage including acute kidney injury and chronic kidney diseases.”
Children’s kidney diseases stay for life and majority of such children progress to end-stage kidney diseases in adulthood. It is crucial to diagnose and prevent the disease early. Experts stressed that there are a host of reasons that can cause chronic kidney ailments in children. “It can be caused by birth defects (children born with one kidney or with kidney abnormalities), hereditary diseases (polycystic kidney disease), infection, nephrotic syndrome (a collection of symptoms with loss of protein in urine and water and salt retention in the body that indicate kidney damage), systemic diseases (involving many organs, including the kidneys, such as Lupus) and urine blockage or reflux (problems of the urinary tract and bladder). From birth to age four, birth defects and hereditary diseases are the leading causes of kidney failure. Between ages 5 and 14, kidney failure is most commonly caused by hereditary diseases, nephrotic syndrome, and systemic diseases. Between ages 15 and 19, diseases that affect the glomeruli are the leading cause,” said Dr Sushma Rani Raju, HoD, Nephrology, SAKRA World Hospital, Bengaluru.
Exorbitant costs keep patients away from transplants
61-year-old Ganesha Ram is still undergoing dialysis thrice a week after being diagnosed with end stage kidney failure. “It is not easy to go to a hospital every day and shell out Rs 1,500 for each dialysis, that too from my own pocket and my life savings,” said Mr Ram, speaking about the financial strains that come with a kidney failure.
Though transplant options are available, exorbitant costs keep patients away. “The dialysis, medicines and other expenses till now have cost me nearly Rs 1 crore,” said 21-year-old Adarsh, a kidney transplant survivor who was diagnosed with a rare kidney disease when he was just two years old. Adarsh said his dialysis sessions which happened thrice a week cost him Rs 3,500 per session, including medicines. “Post-transplant, the expenses have reduced to Rs 15,000 per month from the earlier Rs 30,000,” he said.
Patients stay away from the transplant option because of whopping costs and difficulties in finding donors. “Since it is very costly and emotionally and physically draining, prevention becomes the solution. This means that the high-risk groups should take caution,” said Dr Narendra S., Consultant, Urology, BGS Global Hospitals.
“Our facility conducts nearly 1300 dialysis procedures per month across all ages. We conduct some 40-45 dialyses per day, and there are three shifts. Each session lasts 3-4 hours,” he said.
“I have been managing funds for dialysis and then the transplant from family and friends. Post-2013, the expenses have reduced to '12,000 per month and I have to bear the entire cost,” said 59-year-old Pradeep, who was diagnosed with end stage kidney failure and has been on hemodialysis three times a week for the last five years.
How is kidney disease in children diagnosed
Dipstick test for albumin: The presence of albumin in urine is a sign that the kidneys may be damaged. Albumin in urine can be detected with a dipstick test performed on a urine sample.
Urine albumin-to-creatinine ratio: Unlike a dipstick test for albumin, this is a more precise measurement, and may be necessary to confirm the kidney disease. This is not affected by variation in urine concentration.
Blood test: Blood is sent to lab for analysis and to estimate how much blood the kidneys filter each minute, which is termed the estimated glomerular filtration rate or eGFR.
Imaging studies: Imaging studies provide pictures of the kidneys. They help healthcare provider see the size and shape of kidneys and identify abnormalities.
Kidney biopsy: It involves taking a small piece of kidney tissue for examination with a microscope. Biopsy results show the cause of the kidney disease and the extent of damage to kidneys.
Signs and symptoms of urinary tract or kidney problems vary and include:
- Fever
- Swelling around the eyes, face, feet, and ankles (called edema)
- Burning or pain during urination
- Significant increase in the frequency of urination
- Difficulty in controlling urination in kids who are mature enough to use the toilet
- Recurrence of night time bedwetting (in kids who have been dry for several months)
- Blood in the urine
- High blood pressure
