Abstract Ref Number = APCP80
Challenges management of CKD in children
Division of Nephrology, Dept of Pediatrics, Hasan Sadikin General Hospital Faculty of Medicine Universitas Padjadjaran Bandung, Indonesia
Chronic kidney disease (CKD) is a worldwide public health problem as incidence increased and can progress to end stage renal disease (ESRD). However, data in children are still limited. Various epidemiology and research data is necessary to optimize CKD management in children. The use and utilization of CKD registry in children needs to be socialized.
Basic things that must be included in management of CKD in children are growth and psychosocial problems that will affect the quality of life of children. Two things that become challenges in pediatric CKD management are prevention of the disease itself and also the proper management when the disease occur. Various efforts to prevent CKD in children are uniformity in urinary abnormalities detection programs, such as proteinuria and hematuria, as well as assessing risk factors for CKD, such as recurrent urinary tract infection, fever, nephropathy reflux, drinking water use and prematurity. In addition, agreement on the same nomenclature for CKD staging in children is important and should be socialized between the primary and secondary service physicians, as well as the pediatric nephrologists. Proper management to overcome various complications, such as cardiovascular disease,hematology problems, nutrition status and growth, neurological and neurocognitive abnormalities are become challenging if the disease has occurred. Psychosocial aspects such as school attendance, self-confidence, friendship building, and sports activities also become other challenges in management of children with CKD.
Greater challenges happen in developing countries, because of limitation of resources and funding needs for CKD management. There are only few pediatric nephrologists and the presence are still inequal, and also about renal replacement therapy facilities, as well as expensive drugs such as erythropoietin and growth hormone. The inequalities not only between developed and developing countries, but also within developing countries. The role of Government and other foundation support are needed to give greater attention on handling CKD in children.