Kidney failure in children: prevention and treatment

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Extract from the article: Kidney failure in children is a little-known disease because it is mistakenly thought to be a condition that only affects adults. However, many children live with kidney failure, which is accompanied by an accumulation of waste products in the human

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Kidney failure in children is a little-known disease because it is mistakenly thought to be a condition that only affects adults. However, many children live with kidney failure, which is accompanied by an accumulation of waste products in the human body.

There is no difference between kidney failure in adults and in children.  According to Pr Evelyne Lasme Guilao, Head of the Paediatrics and Neonatology Department at the University Hospital of Yopougon in Abidjan, « there are two forms of the disease. Acute renal failure caused by a severe infection, a state of shock, or an obstacle that hinders the functioning of the bladder. This acute form can evolve into chronic renal failure when the kidney dysfunction extends beyond three months ».

In Togo, a cross-sectional study was conducted over a 12-month period (2016-2017), including children aged 1-18 years hospitalised in the paediatric ward of the Centre Hospitalier Universitaire Sylvanus Olympio in Lomé (Togo) for renal failure. Of 2374 patients hospitalised in the unit, 58 presented with renal failure, a hospital frequency of 2.4%. Renal failure was acute in 55 cases (94.8%) and chronic in 3 cases (5.2%).

Symptoms that should raise alarm

Kidney failure in children can be asymptomatic, which increases the risk. « One of the first symptoms that should alert you to a case of acute renal failure is a sudden drop in the quantity of urine. The child then develops oedema and swelling. Pallor, fatigue and anaemia are also symptoms of kidney failure. In the case of chronic renal failure, there is also a delay in the child's growth », says Professor Evelyne Lasme Guilao.

Common and multiple causes

The causes of renal failure in children are numerous and common. But they do not always lead to acute renal failure if they are well treated. For Pr Evelyne Lasme Guilao, « the most recurrent causes in the African context are: poorly treated malaria, severe infections, acute diarrhoea, congenital malformations, poorly treated sore throats, uncontrolled use of drugs such as anti-inflammatory drugs (aspirin, ibuprofen, etc.), severe burns following accidents with boiling oil or water, and hereditary diseases ».

Prevention to avoid the critical phase

Illnesses that are considered to be benign, such as sore throats or colds, must be treated quickly and appropriately. This is to prevent them from developing into more serious illnesses. « Promote the rehydration of children in case of diarrhoea and vomiting, which is essential to relieve the kidney. Good monitoring of pregnancies with ultrasound scans is essential to detect congenital malformations. Finally, children's blood pressure should be taken regularly because they too can develop hypertension », recommends Pr Lasme Guilao.

An inaccessible treatment for many

The head of the paediatrics and neonatology department at the University Hospital of Yopougon in Abidjan believes that in the case of acute renal failure, dialysis can relieve the kidney and boost its functioning. The sessions are limited in this case and can allow the disease to be definitively reabsorbed. « However, if dialysis is carried out late, the child will develop chronic renal failure. In this case too, dialysis is the treatment applied except for life or while waiting for a kidney transplant. Treatment is expensive and not always accessible. In addition, there is a lack of facilities for the care of children with kidney failure », says the specialist.

In Togo, the Sylvanus Olympio University Hospital in Lomé is currently the only public hospital in Togo to have a haemodialysis centre. Its capacity is limited and the waiting list is over 500 patients. Soon, the CHU of Kara will also house a haemodialysis centre.

William O.