Ekweremadu: Why a Young Person’s kidneys can Fail
Perhaps the only good thing that has come out of the present debacle of former Senator Ekweremadu and his wife is the awareness created about kidney disease in childhood/early adulthood. If you’ve been living under a rock and don’t know what I’m talking about, let me give a summary: a former Nigerian deputy senate president and his wife whose daughter needs a kidney transplant decided to ‘contract’ a donor who was said to be underage (some records show otherwise) whom they sponsored to the UK for the surgery. On getting to the hospital it was found that the boy/man is underaged and didn’t know what he was going in for. Now the senator and his wife are facing charges for organ harvesting which could have them imprisoned for life.
There, you have it.
Whatever comes about this investigation there seems to be one incontrovertible fact, that there is a young lady who needs a kidney transplant.
It may amaze you to know that children too could need kidney transplants. Although rare, cases have increased in the past 2 decades.
How does a child go from being healthy to needing a kidney?
Generally, before a person gets to the point he or she needs a kidney transplant, they get to a stage called End-Stage Kidney (renal) disease. First, there may be an acute injury to the kidneys that one may not be aware of, this becomes irreversible (chronic), and finally, End-stage which requires a transplant. The likelihood that the child dies increases 150 times the normal if a transplant is not done. Knowledge of this may have been why the Ekweremadu family acted so desperately to get a kidney.
What causes Chronic Kidney Disease in Children and Young Adults?
Generally, problems with the kidneys could be structural or functional. Structural in the sense that some children are born with deformed or poorly developed kidneys, have cysts of the kidney, and degeneration of the kidney. It could be functional in the sense that they have problems passing urine, infections of the kidney, etc.
Some causes of kidney disease in young adults include high blood pressure, drugs such as anti-inflammatory drugs used for pain, severe dehydration, smoking, and uncontrolled diabetes.
No matter the initial cause, once chronic kidney disease develops, the pathway is usually similar and progresses to end-stage kidney disease. This is what the young Ekweremadu is facing.
How to suspect Chronic Kidney Disease in an otherwise healthy-looking Child?
Generally, CKD will not show symptoms in the early stages. Some early symptoms to look out for are passing of large quantities of urine and excess urination at night. A simple urine test and blood pressure check at the hospital may lead doctors to suspect a problem in the kidneys.
Other signs and symptoms include low blood levels characterized by pale skin and extreme tiredness. Others are high blood pressure, bone malformation, heart problems, skin changes, loss of concentration, seizures, and coma.
In the young adult, one may notice marked weight loss and swelling of hands and feet. They would also be very tired and breathless, having poor memory and concentration.
What is the outlook for children with CKD?
70% develop End-Stage Kidney Disease by age 20. By 30 only 80% of children with ESKD will be alive.
The most common causes of death are heart diseases like cardiac arrest, stroke, and heart attack. Another common cause is infections.
How do you know a child needs a new kidney?
Doctors measure the Estimated Glomerular Filtration Rate (EGFR) of the kidneys. When this value becomes extremely low it signifies End-Stage Kidney Disease. At this point, the Ekweremadu family would have been given 2 options.
1. Kidney transplant or
2. Dialysis (a machine that takes over kidney function like filtering harmful waste). Patients need dialysis till there is a donor kidney available. One can be on dialysis for several years. In Nigeria, a session of dialysis costs between N40,000 to N60,000. A patient will have about 2 sessions per week.
A kidney transplant costs a minimum of N15 million.