Pt Health Life – Chronic kidney disease can occur at any age. The annual incidence rate of end-stage chronic kidney disease in children under 15 years of age worldwide varies from country to country. The average incidence rate is about 5-6 children under 15 years old/1 million children.
If chronic kidney disease is detected early and managed closely, treatment will bring good results, slowing the progression of glomerulosclerosis and slowing the progression to the final stage. Therefore, understanding this disease is extremely important.
1. Causes of chronic kidney disease
Chronic kidney disease includes stages of kidney disease from the early stages when the glomerular filtration rate has not yet decreased, to the late stages of the disease when the patient requires alternative treatments. Common causes of chronic kidney disease are urinary kidney malformations including:
– Polycystic kidneys include: Posterior urethral valve, neurogenic bladder…
– Glomerular diseases include: Lupus nephritis, nephrotic syndrome …
According to studies, urinary kidney malformations are the main cause in developed countries, most commonly the posterior urethral valve in boys. Chronic kidney disease caused by urinary tract malformations often progresses slowly to the final stage, some studies show that 50 – 65% can still be treated conservatively. Researchers say it is still recognized that the cause of urinary tract malformations is due to genetic mutations.
The next cause of chronic kidney disease in children is glomerular disease . This group of causes accounts for about ¼ of the causes of chronic kidney disease in children.
The frequency gradually decreases in developed countries. One study showed that the cause of chronic kidney disease due to glomerular disease accounts for the highest proportion of the causes surveyed. About 30% of children with chronic kidney disease have glomerular causes. In developing countries, glomerular causes of chronic kidney disease are still high, possibly due to the incidence of Streptococcus infection.
2. Chronic kidney disease is caused by genetic kidney disease
In developing countries, this group of diseases accounts for ¼ of the causes of chronic kidney disease in children. The most common is hereditary kidney disease , chronic tubulointerstitial damage , occurring at 4-5 years old, with urine concentration disorders, frequent urination and progressive kidney failure. In addition, there are other diseases such as: Cystinose, Alport syndrome, Oxalose disease…
3. Signs of chronic kidney disease in children
Each child has different symptoms. For infants and young children, there are often signs of lack of appetite , vomiting and slow physical development. For older children, symptoms may be hidden or manifest with symptoms of the underlying disease.
Children may have symptoms of paleness, anemia , high blood pressure, and digestive disorders .
Drink a lot, urinate a lot, delay puberty. Pericardial effusion, convulsions (when urea increases), itching (due to increased Phosphorus). Osteodystrophy, rickets
Factors causing growth disorders in chronic kidney disease in children are due to lack of nutrition, energy or protein. Chronic dehydration, Na, Potassium deficiency, bone dystrophy, hypertension …
Factors leading to the progression of chronic kidney disease include: Genetic factors such as: Kidneys of low birth weight babies (less than 2500g), premature babies, kidneys of children whose mothers are sick or used nephrotoxic drugs during pregnancy Periods will be more sensitive to injury than other children.
And other groups of factors such as the level of kidney disease caused by underlying diseases include: Glomerular disease, which progresses to kidney failure faster than hypertension, tubulointerstitial disease. The greater the degree of tubulointerstitial damage on kidney biopsy, the faster the kidney failure…
4. What should be done with chronic kidney disease in children?
After diagnosing the disease, depending on each stage and each individual, doctors prescribe appropriate treatment. However, specific treatment general principles: Ensure adequate energy, limit protein. Diet rich in calcium, low in Phosphate.
Correct fluid and electrolyte disorders. If kidney failure has not reached the end stage, salt and water restriction is rarely necessary. Limit salt and water when the patient has edema, high blood pressure, or heart failure .
Diuretics may be used if salt restriction does not respond. If sodium is reduced due to urinary loss, sodium will be compensated according to needs and closely monitored weight, blood pressure, edema and the amount of sodium excreted through urine.
There is usually no need to adjust Potassium much. Limit phosphate in your diet and use phosphate-reducing medication after meals. If calcium is still reduced even though Phosphate is normal, calcium will be supplemented. It is important that patients need regular follow-up examinations every 2 weeks – 1 month, or when there are severe complications. Monitor: Height, weight, blood pressure, blood formula, urea, creatinine, electrolytes, blood gases, urine .
Because chronic kidney disease often progresses silently and without symptoms until the final stage, the important goal is to detect the disease early in 3 high-risk subjects: people with diabetes , hypertension and families with kidney disease. These subjects need to have annual screening tests and proactive treatment early to avoid kidney disease from progressing to the end stage.
Summary: Chronic kidney disease in children greatly affects health and development. When a patient has progressed to end-stage chronic kidney disease, treatment will be expensive and difficult, ultimately involving a kidney transplant .
Therefore, when children get sick, parents need to strictly follow the doctor’s instructions. It is necessary for children to have a normal life. Depending on the severity of chronic kidney disease, patients may be monitored for outpatient follow-up visits. Physical exercise should not be prohibited, except when high blood pressure is present.
