Join Dr. Nisha Krishnamurthy, Consultant in Pediatric Nephrology at Narayana Health SRCC Children's Hospital in Mumbai, ...

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Chronic Kidney Disease in Children: Symptoms &amp; Management

hello everyone I am Dr Nisha krishnam morti the consultant Pediatric nephologist at Nar Health srcc Children's Hospital at Ali Mumbai today I'll give you a brief on the chronic kidney disease in children and also a little bit about the kidney transplants that we do in children at our Hospital chronic kidney disease as the name suggests is a chronic condition of the kidneys which has lasted for more than 3 months and in which the function of the kidney gradually declines over a period of time now this gradual decline in kidney function could be because of a variety of reasons it could be because the children were born with the problem it means that they had some structurally malformed or differently formed kidneys or the urinary tract or it may be because of some disease they may have acquired at a later date that is after birth either in the early neonatal and the infant age or that may have acquired in early childhood depending upon the cause there occurs certain conditions in which the kidney is unable to perform its functions to the optimum and gradually over a period of time this level of function declines because of this decline it may so happen that the children need to be put on additional medications certain diet restrictions and these medications and diet restrictions help to supplement what would normally be the kidney function so the medications may be because they have to control the pot cium in the blood they have to control the phosphorus in the blood it may be because kidney diseases can also give rise to conditions of high blood pressure that is hypertension so to keep all these as well as the acidbase balance in the body because all of these are functions that the kidney performs day in and day out excellently in our body so to supplement this these children have to be put on medications but it so happens that at certain point when the medications alone cannot be enough to supplement this function of the kidney the children may need Additionally the requirement of dialysis which we call the renal replacement therapy dialysis again can be of two forms it can either be a hemodialysis or it can be a peronal dialysis hemodialysis means wherein the dialysis that is the blood is drawn out of the body and the filter that is the kidney what it does in our body the same function is done by a machine outside the blood is passed through that machine and sent back into the child's body similarly we have something called the peritone Dialysis in which the abdominal cavity is used as a mechanism for cleaning the blood and what the kidneys is unable to do we do it via the Peroni both of these procedures are of course there are challenges in doing it but over a period of time the parents the child gets comfortable and of course it is done under the doctors and Hospital supervision so it's fairly safe it can be carried out and we have done dialysis for children as young as 7 months who've been put on these chronic dialysis and we have have allowed the child to grow have a normal lifestyle they go to school they play they participate in various activities and we are able to pull them along till the stage at which probably they will be requiring a renal transplant so typically dialysis works as a bridge to a final condition of renal transplant which is a more definitive solution for the problem of chronic kidney disease transplant involves that a new kidney is placed into the body of the child so that this new kidney can take on the function and the child is able to lead a fair normal life after without having any dialysis however they may be on long-term medications now kidney transplant is a procedure of course is very challenging given that we're doing it in such young children but we have learned and come up with state-ofthe-art medications as well as processes that are helping us and children are doing very well post the kidney transplant the procedure involves and going by our state laws the kidney that is the new kidney is usually taken from the donor which is either of the pair parents of the child or either of the grandparents maternal or paternal and we do this because it is always easier for the child to have a partly genetically matched kidney as against taking it from a c donor however that too can be an option so kidney transplant involves that a new kidney is surgically placed in the child's body and then under careful monitoring at the hospital and subsequently at home the children are kept on medications and under our watch and supervision we uh wait to see that the new kidney is accepted well by the child and it starts functioning to its Optimum capacity and the child is Then followed up so that that they absolutely able to read a perfectly normal life after and as far as the donor is concerned because they are the ones giving the kidney a whole battery of tests is run on the donor so that they don't have to suffer any issues for having given the kidney a lot of priority is given for the donor health so that they will never have to for any issues for having donated the organ and they too are kept under the supervision of an adult nephologist and they lead of absolutely normal life uh for as they would have otherwise LED because one single kidney is enough for a person to lead a normal life for their age expectancy so overall we would encourage that the awareness of the kidney uh related diseases as well as the treatment option we would like to increase the awareness about it in children as well as amongst their patients so that no child has to suffer for the lack of the dialysis or for the lack of an organ replacement thank you [Music]

Dr.

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