Most people assume that kidney failure is only a problem for people over 50 with diabetes and high blood pressure. Few people realize that even newborn babies can suffer from kidney failure.
Josephine Mulwa is a mother of 4 from Kavilinguni Village, Kangundo Sub-County, Machakos County. A week after her baby was born she found out that the newborn had acute kidney injury.
She was baffled as to why her newborn baby couldn’t pass urine or looked so pale.
“When my baby started turning yellowish and cold, I knew there was a big problem so I rushed her to the nearest health centre. However, they immediately referred me to Kangundo, then to Machakos Referral Hospital where the baby was diagnosed with acute kidney injury,” Josephine narrates.
Her baby was transferred to Kenyatta National Hospital and was put through dialysis. After a week, he received a clean medical bill. They had to stay in the hospital for several more days while the doctors monitored her child.
“Nurses told me my child developed acute kidney injury because I did not breastfeed well in the first hours of birth,” she explained, “when I gave birth, I could only express about five per cent of milk but now I am supplementing it with baby formula.”
“Breastfeeding is a very important aspect in preventing kidney disease in newborns,” says Rose Gitau, a health officer at Kakuyuni Level 3 hospital, “dehydration sets in immediately because the baby was used to the intrauterine environment where fluids were always plenty.”
Gitau says that a mother needs to be mentally, physically, and financially prepared to breastfeed her baby immediately after birth.
“Mothers should have a strong support system in the hospital and at home, where the nurses show her how to hold the baby correctly to aid in latching and proper breastfeeding and if she is unable to produce enough milk, she should be given supplements to boost their lactation,” she explains, “at home, this new mother should be helped by family members to give her time to concentrate on nursing.”
Children with acute renal injury can present with a variety of symptoms, including severe dehydration and weakness. Some babies may even have convulsions, while others are too weak to awaken and nurse, or they may suffer from dry skin and very cold hands and toes. The main way doctors diagnose acute kidney injuries in newborns is by the inability to pass urin.
Dr Peninnah Muzyoka, a paediatrician in Machakos Level 5 Hospital says that blood tests are done to test potassium levels, which increase when kidneys are injured. Then, the sodium level is checked, followed by a test for urea, creatinine and a test for sodium.
The doctor will decide if a child’s creatinine, potassium, and sodium levels are too high to put them on dialysis.
Dr Musyoka describes that there are 2 types of dialysis – hemodialysis and Peritoneal Dialysis. For children, most doctors recommend peritoneal dialysis.
In order to reach the peritoneum (the inner lining the abdomen), a small cut is made at the belly button.
Fluid is then pumped through a catheter to the peritoneal space. As blood passes the blood vessels, waste products are removed and the excess fluid is drawn into the dialysis solution.
Dr Musyoka states that the fluid will be replaced with new fluid hours later. Within a few weeks, the baby should be able pass urine normally and the kidneys will work properly.
She suggests that the baby be watched and kept well hydrated after dialysis.
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