Research Paper Example: Renal Anomalies in Children

Introduction

The 2016 World Kidney Day focused on creating awareness on renal disease among pediatric patients. Kidney disease is classified alongside lifestyle morbidities, and it is known to commonly affect the old people as the kidneys lose their physiologic function as a result of aging. The general population is thus not aware of the onset of kidney disease in young children and adolescents. However, there is a high prevalence of kidney injury among children and is often misdiagnosed for other diseases (Harambat et al., 2012). Various health organizations dealing with kidney health in the world came together in 2016 to raise awareness among pediatricians, parents, physicians, and caregivers on pediatric kidney disease and to sensitize the involved stakeholders on the pathogenesis, diagnosis, and treatment of children with acute kidney injury, which may progress to chronic kidney disease without appropriate care.

Causes of Pediatric Kidney Disease

The onset of kidney disease in children is early as the prenatal life ((Ingelfinger et al., 2016). Abdominal ultrasound in pregnant mothers can detect urological anomalies in a fetus and allow the doctor take appropriate action (Ingelfinger et al., 2016). There are myriad causes of kidney anomalies in children. Genetic defects are the most common cause of the defects. These disorders are collectively known as Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). These disorders are attributable to genetic problems that lead to a phenotypic defect in one or more kidney parts. Renal tubular hypoplasia, for instance, is a product of chromosomal defects that results in poorly developed kidney cellular structures (Ingelfinger et al., 2016). Another cause of kidney diseases in children is infection. In some cases, dehydration that follows cholera and other water losing infections may cause acute kidney injury that may slowly progress to chronic kidney disease. Atypical hemolytic uremic syndrome as a result of Escherichia Coli infection also causes microangiopathy of the glomeruli (NDDIK, n.d). Wilms tumor, urinary tract strictures and physical trauma are also common cause of acute injury to the kidney. Once the child develops acute kidney injury, they may end up with chronic kidney disease in their adulthood if prompt and appropriate care is not available (Becherucci et al., 2016).

Symptoms of Kidney Disease in Children

Children with kidney disease may present with symptoms akin to those of renal disease in adults. Oliguria, or infrequent urination, may signify a compromised kidney. On further evaluation, the doctor may discover that the child is passing albumin or protein in urine (Ingelfinger et al., 2016). Other complicated biochemical tests like the measurement of urea, creatinine and electrolytes in blood aid in the diagnosis of kidney disease. (Ingelfinger et al., 2016) Once the acute kidney injury progresses to chronic kidney disease, the child may present with features suggestive of cardiovascular disease which include edema and pectoral angina. The blood pressure of these children also fluctuates in chronic kidney disease (CKD). Anemia is a common finding in children suffering from kidney disease as the body fails to produce erythropoietin, a protein that stimulates the production of red blood cells.

Care and Treatment of Pediatric Patients with Renal Disease

There is intensive research to develop the best regimen for children with acute kidney injury. The goal of this research is to prevent the progression of acute kidney injury (AKI) to CKD and end-stage renal failure. Strict blood pressure control, angiotensin-converting enzyme inhibitors, renin-angiontensin-aldosterone system inhibitors, antioxidants and dietary change are some of the recommended changes that may retard the progression of AKI to CKD (Ingelfinger et al., 2016). Nursing care for these patients include adherence counseling and transitioning care from childhood to adult setting.

References

Becherucci, F., Roperto, R. M., Materassi, M., & Romagnani, P. (2016). Chronic kidney disease in children. Clinical Kidney Journal, 9(4), 583-591.

Harambat, J., Van Stralen, K. J., Kim, J. J., & Tizard, E. J. (2012). Epidemiology of chronic kidney disease in children. Pediatric Nephrology, 27(3), 363-373.

Ingelfinger, J. R., Kalantar-Zadeh, K., Schaefer, F., & World Kidney Day Steering Committee. (2016). Averting the legacy of kidney disease-focus on childhood. Kidney Diseases, 2(1), 46-52.

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (n.d). Kidney Disease in Children. Retrieved https://www.niddk.nih.gov/health-information/kidney-disease/children on 6/1/2018