What’s causing chronic kidney disease in children?

Children suffering from chronic kidney disease (CKD) in India is not a rarity. Rather, CKD remains an alarming disease and a major public health challenge with a global prevalence of 15–74.7 cases/million children. There are several factors that can lead to CKD in children, including challenging health systems in some parts of the world, geographical aspects, and genetic and environmental conditions.

Several reports suggest that the incidence of CKD has rapidly increased over the past 20 years. Its causes vary more in children than in adults.

What is chronic kidney disease (CKD)?

Known as a chronic condition in which the kidneys of the patient are permanently damaged, the function of the kidneys decreases and gets worse over time. It can also be decoded as a chronic renal disease that leads to kidney failure in extreme conditions. CKD can affect people of any age and race.

What causes chronic kidney disease in children?

In children, there can be several factors that can lead to CKD such as birth defects, congenital abnormalities and hereditary diseases, like polycystic kidney disease. Furthermore, Frequent Urinary Tract Infections (UTIs) in children should be closely monitored and treated promptly as the abnormalities in the urinary tract can potentially lead to CKD.

There are several kinds of CKDs that can occur among children since kidney function decreases with every stage of CKD. There are usually five stages, and when a child is first diagnosed, it can be in any of these stages. In most cases, not every child progresses from Stage 1 to 5.

What are common symptoms of chronic kidney disease in children?

While the symptoms may vary from child to child, there are some common ones that occur once CKD progresses. Some of these are as follows:

1) Loss of appetite and fatigue
2) Puffiness or swelling around eyes, feet and ankles
3) Prolonged bed-wetting or frequent urination in children who are five years or older
4) Poor growth in comparison to other children of the similar age group
5) Chronic nausea
6) Severe and frequent headaches
7) Conditions of anemia due to decreased red blood cell production

How to diagnose chronic kidney disease

There are several ways to diagnose CKD. In some cases, kidney problems are found even before the birth of the child via ultrasound. In other cases, children are diagnosed with other conditions where kidney problems are more common.

Additionally, there are several other health concerns among children that lead to a diagnosis of CKD. The below-mentioned tests are usually run by pediatricians to diagnose CKD depending upon a child’s health issues or symptoms:

1) Ultrasound and X-rays: One of the most potent ways of detecting CKD is via ultrasound or X-rays, where the pictures of the kidney help in showcasing any damage to it or its surrounding structures. Ultrasound and X-rays also help in giving hints about what could have caused the kidney problem.

2) Urinalysis: Many a time, pediatricians suggest the analysis of a child’s urine which is collected to detect strands of protein. The presence of protein in the urine can be a sign of kidney damage.

3) Blood tests: Blood tests can show many things, including kidney function levels, chemical levels in the blood and red blood cell levels, all of which help in controlling kidney function levels.

4) Biopsy: In extreme conditions, a kidney biopsy can be conducted, where a small piece of kidney is taken out and examined under a microscope to determine the extent of damage that has happened to the kidney.

Possible ways of treating chronic kidney disease in children

While CKD leads to permanent kidney damage in children that cannot be cured, there are several developments in medical science that have led to major improvements in taking care of children with CKD. In several ways, the progression of the disease can be slowed down and can also prevent children from other serious conditions that can occur in the future.

The major goals of the CKD treatments are:

1) Treating the conditions that have led to CKD

2) Ensuring slow progression of CKD with proper diet and medications

3) Controlling the symptoms through constant monitoring and evaluation of the stage of CKD.

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