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Children, the Link Between Diabetes and Kidney Disease

March is National Kidney Month. Communities across the country are coming together again this year to raise awareness around research, diagnosis, and treatment. Kidney disease currently affects some 37 million people in the U.S.

Typically seen in adults aged 65 and over, kidney disease is now becoming more prevalent in children and adolescents. In 2017 the Centers for Disease Control and Prevention reported that in the U.S. almost 10,000 children where living with end-stage kidney failure and were relying on life-saving dialysis or had a kidney transplant.

The kidneys, two bean-like shaped organs approximately the size of a fist, are located near the middle back, one on either side of your spine, just under the rib cage. Each kidney is connected to the bladder by a thin tube call the ureter. A normal working set of kidneys filter approximately 30 gallons of blood each day to remove waste products and excess water out of the body, through the urine.

The kidneys also control blood pressure, produce hormones to prevent anemia, make red blood cells, and keep bones healthy. In the early stages of the disease most people have no symptoms at all. As the disease progresses and damaged kidneys cannot filter blood properly, wastes build up and problems such as high blood pressure, anemia, weak bones, and nerve damage may occur.

The Centers for Disease Control and Prevention underscores the underlying issue to this complex health condition.

“There’s a growing type 2 diabetes problem in our young people. Until recently, young children and teens almost never got type 2 diabetes, which is why it used to be called adult-onset diabetes. Now, about one-third of American youth are overweight, a problem closely related to the increase in kids with type 2 diabetes, some as young as 10 years old. People who are overweight, especially if they have excess belly fat, are more likely to have insulin resistance, kids included. Insulin resistance is a major risk factor for type 2 diabetes,” it reports.

Children and adolescents with diabetes are at an increased risk for kidney disease as high blood glucose levels can damage the kidneys over time. According to the National Kidney Foundation, approximately 90 percent of those with chronic kidney disease don’t know that they have it.
In many cases diabetic kidney disease and conditions related to diet can be prevented or controlled.

Kidney stones certainly wasn’t on the mind of Loren Carroto, who detailed her experience at the Children’s Hospital of Pittsburgh, when she brought her daughter Bella, then 4 years old, to see her pediatrician in 2009. Because of blood in Bella’s urine her doctor suspected a urinary tract infection.

After more tests failed to find a cause, the pediatrician recommended referring Bella to a pediatric nephrologist, a doctor that specializes in diseases and conditions of the kidneys in children.

“Further tests revealed excess calcium in Bella’s urine, indicating that she was at risk for kidney stones. A CT scan confirmed the diagnosis. Bella’s stomach flu of fevers, vomiting and abdominal pain had actually been kidney stone episodes,” Carroto recalls. “At four years old, we had no idea it could be [her kidneys].”

Initially a special diet was prescribed for Bella with increased fluid intake to try and prevent stone formation. After a few months trying diet-only treatment, it looked like medication might be needed as well, and Bella was prescribed Diuril, a diuretic often used to decrease the calcium in the urine. In Bella’s case, the drug helped decrease the amount of minerals building up in her kidneys.

“It was a miracle drug,” Carroto said. “We gradually found the dosage that worked best for her. Bella has not had one episode since. Managing it is a daily discipline of medication, hydration, and careful attention to diet.”

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