General Articles about Kidney Diseases

Chronic kidney disease is a worldwide public health problem with an adverse outcome of premature death.
CKD affects approximately 195 million women worldwide and it is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.
The risk of developing CKD is at least as high in women as in men, and may even be higher. According to some studies, CKD is more likely to develop in women compared with men, with an average 14% prevalence in women and 12% in men.
However, the number of women on dialysis is lower than the number of men.

At least three major reasons are recognized so far:

CKD progression is slower in women compared to men.
Psycho-socioeconomic barriers such as lower disease awareness lead to late or no start of dialysis among women.
Uneven access to care is a major issue in countries with no universal access to healthcare.

Kidney transplantation is also unequally spread, mostly due to social, cultural and psychological aspects.
Even in some countries that provide kidney transplantation and equitable treatment for men and women, women tend more often to donate kidneys and are less likely to receive them.

CKD is also considered a risk factor for adverse pregnancy outcome and reduced fertility.
Women who have CKD are at increased risk for negative outcomes for the mother and the baby.
Pregnancies in women with advanced CKD are most challenging with high rates of hypertensive disorders and preterm births.
On dialysis, results improve with intensive (daily or nearly daily) dialysis treatment, thus calling for dedicated programs for women of childbearing age.
In successfully transplanted women, fertility can be restored and chances of successful birth increase.
However, as complications are observed more often than in the general population, preconception medical counselling should always be sought.
There is a clear need for higher awareness on CKD in pregnancy, to timely identify CKD in pregnancy, and to follow-up women with CKD during and after pregnancy.
In turn, pregnancy-related complications increase the risk of kidney disease:

pre-eclampsia: a syndrome in which a defect of the implantation of the placenta affects normal kidneys inducing hypertension and proteinuria. It is one of the 3 leading causes of maternal mortality.
septic abortion (infection of the placenta).
post-partum haemorrhage (major bleeding after giving birth.

Children with CKD or kidney failure face many challenges, which can include:

Kidney disease can affect children in various ways, ranging from: treatable disorders without long-term consequences to life-threatening conditions.
Acute kidney disease develops suddenly, lasts a short time, and can be serious with long-lasting consequences or may go away completely once the underlying cause has been treated.
While chronic kidney disease (CKD) does not go away with treatment and tends to get worse over time.

Causes of kidney disease in children classified according to the age:

The treatment for kidney disease in children depends on the cause of the illness.

A child may be referred to a pediatric nephrologist for treatment.

From birth to age 4, birth defects and hereditary diseases are the leading causes of kidney failure.
Between ages 5 and 14, kidney failure is most commonly caused by hereditary diseases, nephrotic syndrome, and systemic diseases.
Between ages 15 and 19, diseases that affect the glomeruli are the leading cause of kidney failure, and hereditary diseases become less common.

And there are other causes:

So how to keep them healthy ??

For children with CKD, learning about nutrition is vital because their diet can affect how well their kidneys work.

Parents or guardians should always consult their child’s health care team before making any dietary changes.

Staying healthy with CKD requires paying close attention to the following elements of a diet:

Protein: Children with CKD should eat enough protein for growth while limiting high protein intake.

Too much protein can put an extra burden on the kidneys and cause kidney function to decline faster.

Protein needs increase when a child is on dialysis because the dialysis process removes protein from the child’s blood.

Sodium: The amount of sodium that children need depends on the stage of their kidney disease, their age, and sometimes other factors.

The healthcare team may recommend limiting or adding sodium and salt to the diet.

Potassium: Potassium levels need to stay in the normal range for children with CKD, because too little or too much potassium can cause heart and muscle problems.

Children may need to stay away from some fruits and vegetables.

The healthcare team recommends the amount of potassium a child needs.

Phosphorus: Children with CKD need to control the level of phosphorus in their blood, because too much phosphorus pulls calcium from the bones, making them weaker and more likely to break, this action is due to stimulation of parathyroid hormone.

child may need to take a phosphate binder with meals to lower the concentration of phosphorus in the blood.

Fluids: Early in CKD, a child’s damaged kidneys may produce either too much or too little urine, which can lead to swelling or dehydration.

As CKD progresses, child may need to limit fluid intake.

The healthcare provider will tell the child and parents or guardians the goal for fluid intake.