Awareness letter for Doctors and parents
Dear Colleague,
It is our pleasure to inform you that we are providing facility to
investigate and treat those children who have kidney problems.
As you know it is very important for all the kidney diseases, prevention
is always better. If we detect the problems early then we can manage
them early before the child develops complications.
First let us see which are the kidney problems seen in children.
When mother is expecting a baby usually antenatal sonography is
done. Kidney malformations are the easiest anomalies which can be
picked up on antenatal scan. Various problems like single kidney, Horse
shoe kidney, ectopic kidney, hydronephrosis, hydroureter, echogenic
kidneys, multicystic dysplastic kidney, oligohydramnios,
polyhydramnios etc can be easily detected on antenatal sonography.
Once any of the above is detected it is advisable that a pediatric
nephrologist, s opinion is taken. Pediatric nephrologist can guide
regarding continuation of pregnancy, how to evaluate further once
baby is born, what measures can be taken to prevent further damage
to functioning kidney and on follow up of these children one can assure
that blood pressure, growth and kidney function is satisfactory and if
not early therapeutic measures can be planned.
If kidney anomalies are not picked up on antenatal sonography then
the child may remain either asymptomatic or develop fever during
infancy.
While investigating a febrile infant it is very crucial to ask for urine
routine and culture sensitivity. If this is not done then it is not possible
to pick up urine infection and again one more opportunity to detect
underlying malformation is missed. Also studies have shown that if
urinary tract infection is diagnosed and treated early then risk of
damage (Scarring) of kidney decreases.
During childhood there are various other problems which can surface
as the child increases in age. Nephrotic syndrome usually develops in
children between 2 -6 years of age. If high index of suspicion is kept and
early referral is done to pediatric nephrologist then one can prevent
severe edema formation, investigate properly on time, educate parents
properly and help in managing a child with chronic problem with a
tendency to relapse.
Other problem where a pediatric nephrologist consultation is essential
is a child with red urine (Hematuria). There are various possibilities
when a child passes red urine and the causes vary from minor problems
like dug induced hematuria, hypercalciuria to glomerulonephritis, thin
membrane disease, Alport s syndrome, renal calculi or Ig A
nephropathy. Consultation with a pediatric nephrologist definitely
helps in detecting the underlying cause for the red urine.
Nowadays we have very good neonatal intensive care units. Every
effort is made to save every baby born by normal means or by assisted
fertilization. We see increased number of babies with prematurity and
low birth weight. It is very essential for both doctors and parents to
know that these babies need long term follow up to check their blood
pressure, growth and kidney function as these babies are likely to be
born with less number of functioning kidney units (Nephrons) and are
likely to have problems in future.
With sepsis, use of nephrotoxic drugs, illnesses like malaria, dengue,
and sickle cell diseases one can see renal function impairment in both
neonates and older children and in such situation again a pediatric
nephrologist can be of a great help.
Please remember that a pediatric nephrologist is a pediatrician who has
obtained further training and skills to look after those children who
have kidney problems. Also these doctors see only those children who
have kidney problems so can devote enough time, education and
guidance to the parents who are in need of it.
Dr. Kamini Mehta is a pediatric nephrologist who is consulting
exclusive pediatric nephrology since last 12 years in city of Mumbai.
She is a pediatrician who has done her formal training in nephrology,
acquired DNB nephrology degree and has further trained herself from
Sydney children s hospital, Sydney, Australia.
If you think a child has a suspicion of underlying kidney problem it is
always better to refer early to prevent kidney damage as prevention is
the best form of treatment.
Thanks