Recently, Indonesia has been quite lively with the increasing number of cases of acute kidney failure occurring in children aged 6 months to 18 years. As of October 18, 2022, there have been 189 reports with a death rate of 99 children. Acute kidney failure, commonly known as acute kidney injury itself is a condition in which a person's kidneys stop functioning suddenly.
What Causes Acute Kidney Failure in Children?
In general, the causes of acute kidney failure are quite diverse, such as impaired blood flow to the kidneys, blockages in the urinary tract, and kidney disorders. However, currently, the causes of acute kidney failure that occur in children themselves are still being investigated and are suspected to be related to adenovirus infection, leptospirosis, as well as the effects of drugs in syrup form which are suspected of having ethylene/diethylene glycol content exceeding the established safe limit.
What Are the Symptoms of Acute Kidney Failure in Children?
In conditions of acute kidney failure that occurs in children, there are several symptoms that parents need to watch out for, including:
- Increased body temperature or fever,
- Indigestion (vomiting, diarrhea, etc.),
- Respiratory disorders (cough, runny nose, shortness of breath, etc.),
- Disorders of the urinary tract such as not being able to urinate for up to 6-8 hours,
- Decreased volume of urine output to <0.5 ml="" kg="" body="" weight="" hour="" within="" 6-12="" hours="" li="">
- Urine is brownish or more concentrated
- seizures
- Decreased consciousness
Diagnosis of acute renal failure
To detect acute kidney failure, the doctor will carry out a physical examination and supporting examinations which include:
- A blood test that measures creatinine and urea levels, which are usually elevated in patients with acute kidney failure, and measures the glomerular filtration rate (glomerular filtration rate) in order to assess the severity of acute kidney failure.
- A urine test aims to measure the volume of urine that comes out and the levels of electrolytes contained in it.
- Body scan through ultrasound, CT scan, or MRI functions to see the condition of the kidneys and detect tumors or blockages that occur in the urinary tract or blood vessels to the kidneys.
- Kidney biopsy to detect disorders in the kidney tissue
How to treat acute kidney failure in children?
In dealing with related cases, the Indonesian Ministry of Health issued Decree of the Director General of Health Services Number HK.02.02./2/I/3305/2022 concerning the Management and Clinical Management of Atypical Progressive Acute Kidney Injury in Children in Facilities Health services as part of increasing awareness. The letter states that after receiving a positive diagnosis of acute kidney failure, the patient will receive treatment in the intensive care unit (HCU/PICU) and receive monitoring from the health facility which includes monitoring of fluid volume balance, and diuresis, consciousness, Kussmaul breathing, blood pressure, and serial creatinine checks. every 12 hours. During the treatment process, the patient will also be given drugs and Intravenous Immunoglobulin (IVIG) which can only be given by the hospital after submitting an application to the Directorate General of Pharmacy and Medical Devices, Ministry of Health.
How to Prevent Acute Kidney Failure in Children?
There are several preventive measures that parents can take, including:
- Ensuring clean and healthy living behavior has been implemented
- Routinely apply hand washing
- Providing balanced nutritious food and not snacking carelessly
- Ensure the maturity of the water you drink
- Ensuring routine and completed child immunizations
Those are the causes, symptoms, diagnosis, and treatment of acute kidney failure in children. If you find your child or relative experiencing similar symptoms, immediately consult a doctor at a trusted hospital for treatment and follow-up.
The article was written by dr. Andina Chrisnawati R, Sp.A, M.Kes (Child Specialist at EMC Alam Sutera Hospital).