Obesity can lead to kidney failure

03rd November 2017
Dr Mosalakatane Source:The Midweek Sun

“I hope no one else has to go through what we did,” Thabo Selome said sighing. The Maun-based engineer’s daughter, now 16 years old, suffered a kidney condition for close to a decade. In 2006, Lorato*, who was then five, started developing swelling under her eyes. “She was not able to walk fast or run and she got tired easily,” said Selome. A visit to the hospital and a urine test later, doctors diagnosed her with Nephritic syndrome, a condition, as Selome explained it, where “protein leaks through the kidneys”. According to the National Kidney Foundation, Nephritic syndrome can occur when the filtering units of the kidney are damaged. This damage allows protein normally kept in the plasma to leak into the urine in large amounts, which reduces the amount of protein in one’s blood.

Lorato was put on treatment immediately, which continued for the next four years, but all of it worked only like a temporary solution to control the disease. She was given steroids, which had their side effects including puffy cheeks and body swelling. She was then put on hemodialysis, the most common method used to treat advanced and permanent kidney failure, for a month.

It was followed by two months of Continuous Ambulatory Peritoneal Dialysis (CAPD), a process where liquid is put into the patient’s abdomen through a catheter to remove waste and extra liquids from the body. This can also be done at home, which is what Selome and his wife did. “But we could not stand it for more than two months. It was painful and is an uncomfortable process especially for a child.

Also mobility is an issue, you can’t go anywhere. Cold weather can be a problem and there is a need to maintain strict hygiene the entire time,” he shared. Finally in 2012, Lorato underwent a completely steroid-free kidney transplant in India with her mother as the donor. She now leads a relatively normal life and is healthy. However, Selome explained that the teenager has to undergo regular check-ups throughout her life, avoid dust and people with contagious diseases. Selome shared his ordeal on the sidelines of the 1st Botswana International Renal Conference held at Cresta Lodge over the weekend. The conference was held under the theme, ‘Sustainability of Renal Care in Developing countries’.

At the event Dr Thembisile Mosalakatane, a pediatrician at Princess Marina Hospital said that Kidney disease in children has become a major public health threat that cannot be ignored, given the increased cases recorded in recent years. “It can also be because more such cases are now being reported. There’s much more awareness around it. Also, earlier there was a bias towards getting boys checked up but not girls, which has now changed,” she said. Kidney disease can affect children in various ways- while some conditions are treatable, others can be life threatening if left unchecked.

Acute Kidney Disease (AKI) is a serious condition that develops suddenly, often lasts a short time and may disappear completely once the underlying cause has been treated. Chronic Kidney Disease (CKD) doesn’t appear with treatment and tends to worsen over time. CKD eventually leads to kidney failure (end-stage kidney disease) and needs to be treated with a kidney transplant or blood-filtering treatments (dialysis) for life. “From observation at our out-patient and in-patient department, nephrotic syndrome is the most common chronic kidney disease in children,” she said.

According to Dr Mosalakatane, a child with nephritic syndrome may only start showing symptoms later in life when the kidney loses its ability to conserve proteins. In this condition, patients often present with a complaint of swelling of the face, abdomen and extremities, which may be confused for an allergic reaction. Unfortunately however, Dr Mosalakatane said unlike in the white population where many of these children respond to treatment, many children with nephritic syndrome in Botswana do not respond to treatment and often end up developing end stage kidney disease requiring dialysis and kidney transplant”. She urged parents to look out for early symptoms of kidney ailments in their children, such as sudden weight gain, unexplained anaemia and weakness, fatigue and recurring urinary infection.

A sedentary lifestyle with no physical exercise, plenty of junk food, less water, can also play a key role in children being affected by kidney ailments. “Obesity can lead to hypertension which in turn will affect the kidneys,” she added. NB: Lorato* is a pseudonym used to conceal the identity of the minor.

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