In this interview with MOTUNRAYO JOEL, a consultant paediatrician, National Hospital, Abuja, Dr. Seyi Oniyangi, discusses issues related to the kidney failure in children
What is 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. Punch
