Doctors say youngsters these days indulge in a lifestyle that put them at considerable health risk - fast foods, aerated drinks, lack of exercise and long hours before a computer or the television, to cite a few of the problem areas.

In its early stages, CKD can largely be managed with medicine. But, once a patient slips into the end stage renal failure, or what doctors regard as CKD-Phase V, life can sustain only on dialysis and drugs or a transplant, both highly expensive options. (While monthly costs of continuous ambulatory peritoneal dialysis work out to Rs. 25,000, besides medicines, hemodialysis would cost around Rs. 5,000 a week besides drugs costs).

Support organisations such as the Tanker Foundation struggle to cope with the shooting demand for subsidised dialysis services. “The demand for care far outstrips what we can provide even after tightened criteria that limit assistance to the underprivileged,” said Stella Matthew, project coordinator of the foundation, which gets at least five referrals every month from nephrologists in the city.

In this scenario, paediatric nephrologists recommend universal screening of schoolchildren for early detection of kidney disorders. A school-based intervention that involves just a simple dip-stick test on a urine sample will be cost-effective against the huge treatment costs after a problem has developed.

“Preventive nephrology is the best long-term option for a resource-strapped setting like ours,” said N. Prahlad of Chennai Pediatric Kidney Foundation. An ultrasound scan once in the first five years of a child’s growth can also detect renal problems at an early stage.

Meanwhile, the nephrology treatment gap is getting bigger owing to the dearth of specialists in paediatric nephrology. “This is where training general practitioners in picking up the important clues during clinical assessment becomes important,” said B. R. Nammalwar, president of Pediatric Kidney Foundation.

In the absence of training, the chances of the disease being detected at an early stage at a non-specialist clinic are fairly remote owing to the silent (asymptomatic) nature of the disorder.

The common tips for GPs include judicious use of antibiotics and non-steroidal anti-inflammatory drugs, avoiding risky combination of drugs or administering a nephro-toxic medicine for a dehydrated patient. Sometimes, chronic constipation or bed-wetting could be the first indicators of a renal problem.

Source-Medindia
SRM/L