On the lookout
UNLIKE its prevalence in adults, kidney disease is fairly rare in childhood. It can, however, affect young children, including newborn babies.
Congenital anomalies of the kidney and urinary tract (CAKUT) is the medical term for birth defects affecting the kidneys. CAKUT can affect one or both kidneys, and different defects often coexist in children.
“Symptoms of kidney diseases vary based on the underlying condition. The presentation of kidney diseases in young children ranges from asymptomatic to life-threatening, but with technological advances, many CAKUT birth defects can be detected through prenatal scans,” says
Dr Lim Han Nee, paediatrics and paediatric nephrology consultant at Regency Specialist Hospital.
Examples of CAKUT include renal agenesis (only one kidney at birth), renal dysplasia (only one functional kidney) and ectopic kidney (kidneys that are located below, above or on the opposite side of where it is supposed to be).
“Children with kidney disease may present with persistent, unexplained fever, swelling around the face and feet, burning or pain during urination, or nonspecific symptoms such as nausea, vomiting, fatigue and appetite loss,” shares Dr Lim.
She adds that kidney injury could develop very suddenly and be cured just as fast, or be serious and life-threatening with long-term consequences.
The latter, called chronic kidney disease (CKD), cannot be cured with treatment and tends to worsen over time.
Compared to acute kidney failure, whose effects can be observed almost instantly, CKD develops slowly and causes the kidneys to deteriorate without significant effects to the body over a long period of time. By the time symptoms are visible and recognisable, it may be too late.
According to Dr Lim, the diagnostic procedure for kidney disease typically involves careful review of signs and symptoms a child exhibits, consideration of medical history and a thorough physical examination by an experienced clinician, preferably a paediatrician.
To confirm the diagnosis, some tests a paediatrician or paediatric nephrologist may order include a urine dipstick test, a urine albumin-to-creatinine ratio test, a blood test, imaging studies of the kidneys and ureter, ultrasonography on the bladder and biopsy of the kidneys.
“Seek appropriate medical attention early. Do not wait to see what happens when symptoms present themselves.
“It is important to differentiate between normal health problems and more obscure symptoms in your child. For healthy individuals, prevention of CKD in adulthood starts as early as in infanthood,” concludes Dr Lim.