Consumption of sugary foods and drinks among children has become a troubling habit, with far more serious health implications than expected.
This habit not only fuels obesity but also increases the risk of life-threatening chronic diseases, such as kidney failure. In Jakarta, hundreds of children have developed kidney failure. This emphasises the importance of earlier and effective medical intervention and increased public awareness of the dangers of unhealthy diets.
Rising Cases of Kidney Failure among Children
Recent data from the DKI Jakarta Health Office shows that as many as 439 children in the capital city have been diagnosed with kidney failure by 2023. This figure not only reflects the increasing prevalence of kidney disease among children but also indicates that the disease is now a pressing health issue in Indonesia. Currently, around 60 children routinely undergo dialysis therapy at Dr Cipto Mangunkusumo National Central General Hospital (RSCM). Therefore, it is clear that this condition requires immediate attention and action to prevent further damage and complications that may arise.
From Obesity to Kidney Failure
Kidney failure in children is often the result of an accumulation of various interrelated medical conditions. Obesity, which is becoming increasingly common in children due to excessive sugar consumption, is one of the main risk factors. Obese children not only face weight problems but are also prone to various other chronic diseases. One of the most prominent is hypertension, or high blood pressure, which can significantly impair kidney function. Apart from obesity and hypertension, there are several other causes that can trigger kidney failure in children, including:
Kidney Damage: Severe kidney damage can lead to kidney failure. This can be caused by infection, injury, or certain diseases such as glomerulonephritis.
Obstruction or Blockage: Obstruction in the urinary tract can disrupt blood flow to the kidneys. This can then subsequently lead to kidney failure.
Chronic Diseases: Chronic diseases such as diabetes mellitus can increase the risk of kidney failure due to progressive kidney damage.
Infections and Allergies: Severe infections or severe allergic reactions such as anaphylaxis can also lead to kidney failure.
Exposure to Chemical Compounds: Chemical compounds such as Ethylene Glycol (EG), Diethylene Glycol (DEG), and Ethylene Glycol Butyl Ether (EGBE) contained in certain medications can cause kidney damage.
Viral Diseases: Viral diseases such as COVID-19 have also been suspected as a cause of acute kidney failure in children.
Often Overlooked Triggers of Kidney Failure
Hypertension in children is often overlooked, even though this condition can cause permanent damage to the kidneys. High blood pressure causes the blood vessels in the kidneys to thicken and harden, reducing the kidneys’ ability to filter blood efficiently. This slow but steady process often shows no obvious early symptoms, so many cases are only detected at an advanced stage. Eventually, this kidney damage can progress to chronic kidney disease that requires lifelong treatment. Some steps that can be taken to prevent and manage hypertension in children include:
Blood Pressure Monitoring: Conduct regular blood pressure monitoring to detect hypertension early.
Dietary Management: Eat a balanced diet that is low in salt, and reduce sugar and fat consumption.
Physical Activity: Regular physical activity to maintain heart and kidney health.
Stress Reduction: Reduce stress with relaxation techniques such as meditation, yoga, or talking to a psychologist.
Obesity Surveillance: Monitor the child’s weight to prevent obesity, as obesity is often associated with hypertension.
Treatment: If hypertension is found, then appropriate treatment should be taken with the help of a doctor. Treatment will include the use of appropriate medications and lifestyle changes.
Double Threat to Kidney Health
Besides obesity and hypertension, type 2 diabetes also contributes greatly to the increasing cases of kidney failure in children. Type 2 diabetes, usually caused by an unhealthy lifestyle, is becoming increasingly common in the paediatric population. People with diabetes suffer chronic hyperglycaemia, a condition where blood sugar levels are constantly high and damage the nephrons, the basic filtering units in the kidneys. This nephron damage leads to diabetic nephropathy. It is a condition in which the kidneys progressively lose their function, eventually forcing the patient to undergo dialysis or a kidney transplant.
Pathophysiology of Renal Failure in Children
A thorough understanding of the pathophysiology of renal failure is essential for developing effective prevention and treatment strategies. The process begins with damage to the glomerulus, the main filtering tissue in the kidney, which occurs due to high blood pressure. This damage leads to proteinuria, a condition where proteins that should be retained in the blood leak into the urine. Over time, the damage progresses to other parts of the kidney. This include the tubules and interstitium, leading to fibrosis, a process of scar tissue formation that replaces healthy kidney tissue. This fibrosis further reduces the kidney’s ability to function, eventually leading to terminal renal failure.
Prevention of Kidney Failure
Prevention of kidney failure should start early, with strong education on the importance of balanced nutrition and physical activity for children. Parents, teachers and the entire community have an important role in teaching children to avoid excessive sugar consumption and lead a healthier lifestyle. Regular health check-ups are also highly recommended for early detection of hypertension or diabetes so that medical interventions can be made before the disease progresses further.
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