As a specialist in the treatment of urinary tract and kidney diseases in babies, children and adolescents, paediatric nephrologist Dr Rashinta Moodley sheds some light on kidney disease in children.
“Due to developmental problems during pregnancy, many babies can be born with kidney and urinary tract abnormalities. Nephrotic syndrome is common in children- this is a condition where large quantities of protein are lost in the urine. There can also be obstructions in the urinary tract. Infections can also affect the kidney resulting usually in temporary loss of function. Any progression of these conditions can lead to chronic kidney failure.”
Dr Moodley says the warning signs are decreased amount of urine passed, swelling of the face and body, recurring urinary tract infections, blood in the urine, and incontinence.
“Treatments depend on the cause of the kidney disease, example, Nephrotic syndrome is treated with intravenous protein replacement and steroids, but often stronger immunosuppressants are needed. Obstructive/developmental abnormalities of the urinary system may require surgical intervention. Kidney disease can progress to kidney failure, at which point dialysis and transplantation will be necessary. Depending on the child’s condition and response to treatment or surgery, the prognosis can be very good. However, once the patient has renal failure, the prognosis depends on the success of dialysis and kidney transplantation.”
Dr Moodley says she strives to treat a child with the fewest number of drugs and manage their kidney condition for as long as possible before resorting to dialysis. “It is rewarding to see a child in remission, with minimal side effects, and it is especially satisfying to find a live, related donor and achieve a successful transplant. Parents are often willing to donate a kidney to their child (an adult’s kidney can be transplanted into an infant as long as the clinical and donor matching criteria are met) but if the parent or other family members are not suitable donors, the child may have a long wait before a cadaver organ is available.”Dr Moodley has been in private practice since 2015 and is currently consulting at Life Entabeni Hospital, Life Mt Edgecombe Hospital and The Gateway Private Hospital. She can also admit patients to Netcare Umhlanga Hospital and Netcare St Augustine’s Hospital.