Combatting Kidney Disease in Children: Importance of Early Detection and Education
Kidney disease affects millions of people
worldwide, including many children who may
be at risk at an early age. It is therefore
crucial that we encourage and facilitate
education, early detection and a healthy life
style in children, to fight the increase of
preventable kidney diseases and to treat
children with inborn and acquired disorders
of the kidneys worldwide.
Edited by the ASPN Clinical Affairs Committee
David Hains, MD
◦
LeBonheur Children’s Hospital, University of
Tennessee Health Science Center
Vesicoureteral reflux
(VUR):
•
Abnormal
backflow of
urine
•
Prevalence is at
least 1-2%
Craig JC, et al. J Am Soc Nephrol 19: 847–862, 2008
•
8% girls/2% boys have UTI in first 6 yrs of life.
•
>1.4 million annual physician office visits ($8 Billion).
•
~50,000 children hospitalized annually with UTI
diagnosis.
◦
Estimated annual economic burden of inpatient treatment: ~$180
million
Montini et al.
NEJM
2011; 365(3)
AAP Clinical Practice Guideline.
Pediatrics
2011; 128(3)
Freedman et al.
J. Urology
2005; 173(3)
Spencer et al.
Ped Neph
2010; 25(12)
UTIs
Scarring
Hypertension
CKD/ ESRD
http://www.medscape.org/viewarticle/432641
Goals:
•
Prevent UTIs
•
Limit side effects
•
Prevent renal scarring
Strategies:
•
Antibiotic prophylaxis
•
Conservative management
•
Corrective procedures
Estrada CR, et al. Journal of Urology 181:229, 2009
Lee RS, et al. Pediatrics 118:586, 2006
Penido Silva JM, et al. Pediatr Nephrol 21:86, 2006
No recurrence,
71%
Recurrence, 29%
Slide from Russell Chesney
Hoberman et al. N Engl J Med. 2014
Sep11;371(11):1072-3.
There are still unanswered questions
regarding an optimal evaluative and
therapeutic approach.
An appropriate strategy must be tailored to
the individual patient and family.
Don’t forget to ask about dysfunctional
elimination syndrome and address it if
needed!
Your pediatric nephrology community
continues to work hard to improve clinical
care, foster education, and advance the science
regarding kidney disease in children! We
appreciate your support and all you do for
children’s health care!
Kidney disease affects millions worldwide, including children at risk from an early age. Encouraging education, early detection, and a healthy lifestyle is crucial to combat preventable kidney diseases. Various disorders like Vesicoureteral Reflux (VUR) and UTIs pose significant challenges, emphasizing the need for awareness and proactive management strategies. Addressing these issues can help prevent renal scarring, recurrent UTIs, and long-term complications in children. Collaborative efforts are vital in tailoring optimal evaluative and therapeutic approaches for individual patients and families.
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Presentation Transcript
Kidney disease affects millions of people worldwide, including many children who may be at risk at an early age. It is therefore crucial that we encourage and facilitate education, early detection and a healthy life style in children, to fight the increase of preventable kidney diseases and to treat children with inborn and acquired disorders of the kidneys worldwide.
David Hains, MD LeBonheur Children s Hospital, University of Tennessee Health Science Center
Vesicoureteral (VUR): Abnormal backflow of urine Prevalence is at least 1-2% Vesicoureteral reflux reflux Craig JC, et al. J Am Soc Nephrol 19: 847 862, 2008
8% girls/2% boys have UTI in first 6 yrs of life. >1.4 million annual physician office visits ($8 Billion). ~50,000 children hospitalized annually with UTI diagnosis. Estimated annual economic burden of inpatient treatment: ~$180 million Montini et al. NEJM 2011; 365(3) AAP Clinical Practice Guideline. Pediatrics 2011; 128(3) Freedman et al. J. Urology 2005; 173(3) Spencer et al. Ped Neph 2010; 25(12)
UTIs Scarring CKD/ ESRD Hypertension http://www.medscape.org/viewarticle/432641
Goals: Prevent UTIs Limit side effects Prevent renal scarring Recurrence, 29% No recurrence, 71% Strategies: Antibiotic prophylaxis Conservative management Corrective procedures UTI 20% No UTI 80% Estrada CR, et al. Journal of Urology 181:229, 2009 Lee RS, et al. Pediatrics 118:586, 2006 Penido Silva JM, et al. Pediatr Nephrol 21:86, 2006
Hoberman et al. N Engl J Med. 2014 Sep11;371(11):1072-3. Slide from Russell Chesney
There are still unanswered questions regarding an optimal evaluative and therapeutic approach. An appropriate strategy must be tailored to the individual patient and family. Don t forget to ask about dysfunctional elimination syndrome and address it if needed!
Your pediatric nephrology community continues to work hard to improve clinical care, foster education, and advance the science regarding kidney disease in children! We appreciate your support and all you do for children s health care! Your pediatric nephrology community continues to work hard to improve clinical care, foster education, and advance the science regarding kidney disease in children! We appreciate your support and all you do for children s health care!
