Kidney Disease in Children

As per discussed in previous articles by Joe Cosgrove, kidney disease can affect individuals in various ways. Children, nonetheless, are not the exception. Just like with adults, kidney disease can affect children in different ways, ranging from treatable, to some extent, conditions or disorders without the already mentioned lasting consequences to really life-endangering complications. Kidney disease, especially acute kidney disease, comes out of nowhere, may even last a short amount of time, may also be serious enough for it to leave children with long-lasting consequence, or may go away after treatment. Chronic kidney disease, however, does not fade away so easily, and it tends to worsen as time passes by. Chronic kidney disease (CKD) eventually evolves into kidney failure, end-stage kidney disease or even end-stage renal failure when dialysis is involved.

Children with chronic kidney disease actually are forced to face many tough and dreary challenges. Some of them include a really negative self-image, some relationship problems, behavioral issues, learning disorders, trouble focusing on what is important, delayed language and motor skills development, amongst others. Children suffering from CKD have shown a much slower growth rate in comparison to their peers; urinary incontinence is also very common.

Are there causes for kidney disease in children?

Kidney disease, regardless of its nature, in children can be caused by several causes: birth defects, hereditary conditions, infections, systemic diseases, trauma, nephrotic syndrome, reflux or urine blockage. From birth to age 5, hereditary conditions alongside birth defects are the most leading causes of kidney diseases and kidney failure. Between ages 6 and 15, kidney failure has been associated mostly with hereditary diseases, the aforementioned nephrotic syndrome and other systemic diseases. After that, between ages 16 and 20, several diseases that affect the glomeruli are the leading cause of acute kidney disease and chronic kidney disease. Hereditary diseases seem to be less common in comparison to early stages of life.

The most common causes explained:

Birth defects and conditions

The term birth defects suggests that a problem has happened while the baby is developing in the womb. Birth defects can range from renal agenesis, to renal dysplasia, and even to ectopic kidneys, just to mention several. These are mainly abnormalities of size, position, and structure of the organs. Generally speaking, children with these diseases can get to live full and healthy lives; nevertheless, some children end up facing much higher odds of developing a much worse kidney disease.

Kidney Disease in Children_renal compensation_learning_education

Image courtesy of Pixabay at Pexels.com

Hereditary conditions

Hereditary conditions or hereditary kidney diseases are those that are passed from parent to children through genes. One example is the commonly referred to as polycystic kidney diseases or PKD, which is often characterized by the presence of many grapelike groups of cysts (fluid-filled cysts, in this case) that make both organs much larger over time. The cysts often destroy the individual or the children’s working healthy and kidney tissue as time passes by. Alongside PKD, Alport Syndrome, which is often caused by a mutation in a gene, is also common in children. The disease leads to scarring of the organ. This syndrome generally appears in early childhood, and it seems to affect boys more than women. Besides, it evolves into, or causes, hearing and vision issues in addition to the original affection.

Infection

Aside from the aforementioned syndrome, infections also may end up causing other syndromes as well. Acute post-streptococcal glomerulonephritis and hemolytic uremic syndrome are kidney conditions that can develop in children after the presence of a tough infection. The latter is rather a rare condition that is often generated by the E. coli bacteria—mostly found in contaminated foods—. Hemolytic uremic syndrome starts to form when E. coli gets to the digestive tract and the toxins are allowed into the host’s bloodstream. The toxins start to attack the individual’s red blood cells and damage blood vessels while at it. Most children who have E. coli infection often suffer from ongoing episodes of vomiting, stomach cramps and bloody diarrhea for up to three days. They also become pale and show tiredness and irritability. The former, acute post-streptococcal glomerulonephritis, often occurs after episodes of both skin infection or strep throat. The streptococcus bacteria does not go straight for the kidneys; it starts by confusing the immune system, prompting it to produce antibodies in excess. Antibodies are proteins created by the immune system. The immune system is responsible for protecting individuals from different infections by assessing and subsequently identifying and destroying bacteria, viruses and other foreign threats. When the body over produces antibodies and these get to the blood and finally end up being allocated in the glomeruli, the kidneys are at open to suffering heavy damage. Most cases develop within 3 weeks after having suffered an untreated infection. It is nonetheless treatable; however, kidney damage may last forever.

* Featured Image courtesy of Pixabay at Pexels.com

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Baxter ShareSource System: A New Dialysis Option for You

Chronic kidney disease is a quite underestimated subject by ordinary people. This issue is much more socially extended than many people believe, and, in fact, statistics suggest that one in every hundred people may be suffering from this terrible illness today. This problem is one of the main public health issues in several countries, not only because of its disastrous health consequences and because of its high frequency in the population, but because the treatments (dialysis, eminently) to respond to this issue are usually expensive. The main consequence when it comes to chronic kidney disease is that the patient must depend on a kidney transplant or a machine to survive in his or her remaining time of life.

The only option for thousands of people around the world is to sit or lay for three or four hours connected to a machine that removes toxins from the blood system. This is the only way to filter out a series of toxins as well as the excess of fluids in the body, which the kidneys eliminate in normal conditions. This is the normal life situation of millions of patients diagnosed with renal failure who cannot afford a kidney transplant, or who, although they can actually afford it, must wait for a donor for years. The process of dialysis, in any of its forms, must be carried out for life. The body has no vacations, after all.

This therapy has two modalities: hemodialysis, which can be performed three times a week in a health center, and peritoneal dialysis, which is done daily from the home of patients, four times a day. Each month, the specialist in charge of the process monitors the treatment and the condition of each patient and, if something is not going well, he or she makes the appropriate changes to improve the therapy.

Since the end of last year, a new technology allows doctors and patients to change that traditional way of doing dialysis (in any of both ways.) We are talking about the ShareSource platform of Baxter International, a system that automatically transmits (in real time) the data on what is happening with each patient throughout the dialysis therapy. This system not only saves time and money for patients, who no longer have to travel to hospitals or other places where their therapy is carried out, but doctors permanently know if one of their patients stopped using the dialysis system at home, as well as the frequency of use and if it is working properly.

Read also: Great Alternatives to Perform Dialysis at Home, by Joe Cosgrove

This technology for remote patient management was created to improve the patient’s treatment in peritoneal dialysis, in addition to significantly increase the efficiency of hospital centers. This bidirectional communication platform is based on the cloud and is incorporated into the automated peritoneal dialysis system. It not only offers physicians a more accurate and timely visibility of the compliance of the therapy by their home patients, which, in turn, allows the identification and early intervention of possible complications, but it also allows collecting important data that can be later become useful information for new researchers on chronic kidney disease. After all, this system monitors patients permanently. Perhaps, the most positive thing about this technology is the possibility of accessing the patient’s compliance data in time, and thus manage possible clinical complications in advance.

The most common drawbacks that usually occur with dialysis are problems with the catheter performance, which is the hose used for fluid exchange. This is the main cause that usually spoils dialysis treatments. When this kind of issues are identified, the doctor has the possibility of making a prescription to solve what is going wrong with the dialysis on time and avoid hospitalizations or other health complications that may be derived from a poorly carried therapy. This also means saving money to the health system since patients get sick much less.

This may be a good option for those patients who live in remote areas and who find it difficult to travel frequently to health centers to carry out their dialysis therapies or to be checked by their doctors. Actually, thanks to this intelligent system, it is possible to reduce the frequency of medical check-ups to one every two months. This gives patients much more freedom and saves doctors a lot of time.

Video: Connectivity Platform Provides Telemedicine Capabilities for Remote Patient Management

Actually, it is a simple platform to manage, that even works like any smartphone app. There is a main menu which shows a list of patients and what has happened during the last week of treatment with each one of them and generates alerts in case of trouble (if a patient skipped a dialysis session, if there was a problem with the connection, or if there were complications in the process of eliminating toxins, for example.)

Internet and Big Data technology has revolutionized all aspects of human life, including health. In this case, it has meant a great advance, which, in an intelligent and practical way, can help to improve the quality of life of patients, as well as the job of millions of doctors.

* Featured Image courtesy of EdTech Stanford University School of Medicine at Flickr.com

Dialysis: Almost 70 decades of hard work and progress

Like many other medical procedures and aids, dialysis has been around for a while. For the past 70 decades, it has helped thousands (if not millions) of individuals whose kidneys stopped working properly.

Kidneys can fail due to a wide variety of reasons. Sometimes genetics get in the way and make them stop working, or certain environmental conditions or experiences change the way they work and lead individuals to a kidney failure or a chronic kidney disease. This has happened to humans for as long as they have existed and it will probably keep on happening for as long as we are on earth.

Regardless the reason why kidneys fail, for those whose bodies are not able to filter the waste that runs in the blood, undergoing dialysis procedures becomes necessary.

Nowadays, this is a solution easy to picture. But, has anyone asked how we managed to make it until this point? Years of sacrifice and medical progress had to get in the way for us to be able to know dialysis as it works today.

In this article, Joe Cosgrove will share some historical facts related to dialysis.

Back in the 40’s

Dialysis is a 20th-century invention. It was first invented by Dr. Willem Kolff back in 1943 when this young doctor from the Netherlands decided to construct the first artificial kidney or dialyzer.

The process of developing this kidney was long and took Dr. Kolff more than 10 years. It started when he was a student at the University of Groningen Hospital, in his natal country. Kolff watched how a young man died in a painful and slow way because his kidneys fail and there was nothing to be done. This situation inspired Kolff and moved him to create an artifact that could work as the kidneys.

Kolff read every book available at the University’s library that talked about the kidneys and how the filtered waste from the blood. This is how bumped into an article written in 1913 by a famous pharmacologist named John Abel. In this article, Abel described the hemodialysis process in animals. Abel’s work inspired Kolff to create an artificial kidney.

When Kolff was doing his first experiments, the World War II started, forcing him to work at a Dutch hospital in a remote location once the Nazis overtook the country. This hard conditions never stopped him and he kept on working on the artificial kidney project.

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Image courtesy of rob koopman at Flickr.com

Eventually, he came up with a device made with sausage skin, a washing machine, orange juice cans and other items that would allow him to filter waste from the blood. His invention took place under the Nazi domain and risking his life to make it possible.

By 1943, Kolff’s kidney was finished and ready to be tested. Until 1945, 16 patients were treated unsuccessfully. It wasn’t until that same year that a woman with a uremic coma was successfully treated and regained consciousness.

This is how Kolff’s dialyzer became the first one in history successfully used to treat kidney diseases. It became part of the standard treatment for kidney failure for the next 10 years.

There is hope in the 50’s

In the years to come, Kolff’s invention was improved to treat both acute renal failure and chronic stage renal disease. This was a rough path since most doctors in the 50’s believed that patients with kidney problems couldn’t undergo dialysis for long periods of time and that no man could come up with an artificial kidney that could replace the functions of a real one.

Another challenge that had to be faced back then was the strong damage veins and arteries of patients were suffering. This makes hard for patients to take the treatment for long periods of time.

It wasn’t until Professor Dr. Belding Scribner at the University of Washington came up with the idea of connecting plastic tubes to the dialyzer, and inserting one of these tubes into the patient’s arteries and veins, that would remain open for as long as the treatment lasted. These tubes had the shape of a U that would work as a bypass.

Later in time, this device was improved with a new material called Teflon and operated as a dialysis bypass that allowed patients to be treated for longer periods of time, extending their lives until an organ was available for a transplant.

From the 60’s to today

Dialysis Machine_Dialysis on children_joe cosgrove

Image courtesy of Amber Case at Flickr.com

Dialysis patients became numerous and facilities couldn’t serve all of them. Committees would decide who was going to dialysis and who had to wait. This is how bioethics committees were created and healthcare treatments became fairly available for many individuals who needed them. Portable dialysis machines were created and people could undergo dialysis at their homes.

During the past five decades, dialysis machines have been improved by technology. Kidney medicine has also evolved in a way kidney conditions can be treated with multiple alternatives. Some people use the peritoneal dialysis treatment and some other decide to undergo the hemodialysis one. Regardless the options, it is thanks to doctors like Kolff and Scribner that dialysis treatment became real.