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In the past two months, cases of acute kidney failure in middle-aged children have become a problem. How not, this incident is said to have attacked hundreds of children in Indonesia and is still growing.

Despite this, the Indonesian Ministry of Health asked parents to remain calm and not panic. Parents should also be alert if their child is showing the following symptoms of acute kidney failure.


Examples of cases of acute renal failure in children

Acute kidney disease in children is a condition in which the kidneys are damaged and unable to function properly. Similar to adults, kidney disease in children comes on suddenly and can get worse within hours or days. For example, cases of acute kidney failure in children aged 6 months to 18 years, especially young children, are currently in the spotlight.

It is known that since the end of August 2022, the Ministry of Health and the Indonesian Association of Pediatricians (IDAI) has received reports of a rapid increase in cases of atypical progressive acute kidney injury (AKI) in children, particularly in children under the age of 5 years.

The Indonesian Health Ministry website said the number of cases of acute kidney failure in children reported as of October 18, 2022, was 206 from 20 provinces. At the time of publication of this article, this number was followed by a death rate of 99 children, with the mortality rate for patients treated at RSCM reaching 65%.

For this reason, the government, together with related parties, continues to conduct extensive investigations and research, including possible causes and other risk factors for cases of acute kidney disease in children.


What are the symptoms of acute kidney failure in children?

In general, the symptoms of acute kidney failure in children that appear at this time are similar to those of other kidney diseases.

On Friday (10/21/2022) Dr. Henny Adriani, Sp. A(K) said that the symptoms of acute kidney failure in children begin with decreased urine production. A similar statement was made by Dr. M Syahril spokesman for the Ministry of Health. He said if the child has acute kidney failure, the typical symptom is a sudden decrease in urine volume.

Therefore, parents need to continue to monitor the intensity of urination and recognize the color of the urine being passed by the little one, whether it is thick or brown. Ideally, the frequency of urination in children occurs up to 6-8 times a day. As they get older, the child often goes back and forth to pee about 6-7 times a day.

In addition to children peeing less often, there are several symptoms of acute kidney failure that children experience that you need to look out for, such as B. the following.

  • Fever.
  • Diarrhea.
  • Breathing problems such as coughing or a runny nose.
  • Nausea and vomiting.

In more severe cases, your child may have the following symptoms:

  • dehydration.
  • Body swelling.
  • Breathe quickly and deeply.
  • There is an electrolyte disturbance.
  • seizures.
  • have high blood pressure.

If you suspect your child is developing these symptoms, you should contact the nearest healthcare facility immediately for further treatment.

What causes acute kidney failure in children?

Until this article is written, the cause of Acute Kidney Failure is still under investigation to find out for sure. In the examination performed on the remaining samples of the drugs consumed by the patient. From there, traces of compounds have been found that have the potential to cause acute kidney failure in children.

In a written statement on Thursday (10/20/2022), the Food and Drug Supervisory Agency (BPOM) suspected that there was contamination of ethylene glycol (EG) and diethylene glycol (DG) compounds in liquid or syrupy preparations of paracetamol. The compound is known to have crossed the safe threshold, so it is the cause of many children suffering from mysterious acute kidney failure.

However, BPOM stated that it still cannot support the conclusion that syrup is the cause of the many cases of acute kidney failure in children that are currently occurring. There may be other factors that are still being studied, including the susceptibility of the child’s immune system and the environment.

To prevent and raise awareness, the Ministry of Health has ordered all health workers to temporarily stop prescribing liquid or syrup medicines until the results of the search and research are complete. The BPOM also ordered these drugs to be phased out and then destroyed. Alternatively, you can also use other dosage forms such as tablets, capsules, or suppositories (anal).


How to treat cases of acute kidney failure in children?

Synergy and collaboration of all parties, including parents and medical staff, are needed to prevent cases of acute kidney failure in children as early as possible.

As part of the awareness raising, the Ministry of Health has also issued a decree of the Director General of Health Services on the Treatment and Clinical Management of Atypical Progressive Acute Kidney Injury in Children in Health Facilities. This regulation contains a set of activities to be carried out by medical and other health workers to treat patients with acute renal failure according to medical indications.

When the child is sick, make sure to continue drinking water to meet the body’s hydration needs. Also, keep an eye out if your little one is urinating less frequently or not peeing at all for 6-8 hours (during the day). If you see these signs, take your child to the hospital right away. During the hospital stay, further tests for kidney function will be carried out. In the meantime, if renal function increases, further investigations are performed to confirm the diagnosis and evaluate the possible etiology and complications.

In addition, if the test result is positive for acute renal failure, the patient will be treated in an intensive care unit in the form of a High Care Unit (HCU)/Pediatric Intensive Care Unit (PICU) as indicated.

During the treatment process, the hospital provides medication and continues to monitor the patient’s condition, including fluid balance volume and diuresis during treatment. Monitoring was also performed, including patient awareness, Kusmaull respiration, blood pressure, and serial creatinine checks every 12 hours.


Measures to prevent acute renal failure in children

The government also appealed to the public to use drugs properly and properly. Be sure to follow the doctor’s prescription and the information on the medicine packaging.

Here are some simple steps you can take to ensure you are taking your medication correctly and safely for your body.

  • Taking medication according to the instructions for use.
  • Do not take more than the prescribed dose of the drug.
  • Read the warnings on the medicine packaging.
  • Do not take expired medication.
  • Do not consume the rest of the syrup that has been opened and stored for a long time.
  • Avoid unnecessary use of antibiotics to prevent resistance.
  • Report any medication side effects you are experiencing to the nearest health worker.
  • Obtain medication from an authorized or licensed pharmacy service facility.

This is an explanation for cases of acute kidney disease in children.

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