Mumbai: Upto 80 per cent of critically
ill newborns in India suffer from Acute Kidney Injury (AKI),
also known as Acute Renal Failure, experts from Batra Hospital
and Medical Research Centre said Wednesday.
"As many as 30?50 per cent of patients in the
Intensive Care Unit and about five per cent of hospitalised
children overall have this condition. Again, Chronic Kidney
Disease (CKD) together with End Stage Renal Disease (ESRD) has
a worldwide incidence of 75?350 per million population," Dr
Sanjeev Bagai, CEO and Consultant Pediatrician and
Nephrologist, Batra Hospital said on the eve of World Kindey
Approximately 3,00,000 ESRD children exist in India
with fewer than five per cent receiving renal replacement
therapy, he said.
"Kidneys are the corner stone of the body and it helps
maintain metabolic balance, body fluids, salts and blood
pressure. More often injury occurs at a sub-clinical level
with no external manifestations or any changes in the blood
profile, until it is too late," he said.
Thus, failure to recognise significant renal injury
delays treatment and leads to a higher morbidity. This leads
to CKD in later life begin in children, the doctor said.
AKI is commonly precipitated by those including
conditions like Acute Gastroenteritis, blood loss, shock,
inflammation of the Liver (known as Fulminant Hepatitis) and
In this background, assessing kidney function
precisely assumes particular significance.
Early detection of a functional abnormality leading to
a prompt intervention can prevent significant kidney damage.
"Unfortunately, as of now we don`t have many
diagnostic methods or tests in place, which could help us
detect these abnormalities early, especially before the
disease has become clinically manifest," the Center said.
"Kidney function so far is gauged by creatinine and
its small rise increases risk of mortality. Creatinine tends
to be an unreliable indicator of AKI (variations with age,
gender, muscle mass and metabolism, hydration status) and
does not change until 50 per cent of kidney function is lost,"
Asked whether there would be some early diagnostic
tool available, Bagai said, "In the near future there would be
novel biomarkers for early detection and management of kidney
injury including Urine panel of NGAL, IL-18, KIM-1, and Plasma
panel of NGAL and Cystatin C. These biomarkers are sensitive
much before rise in Serum creatinine."
The symptoms and signs are often subtle and hidden.
Laboratory investigations include detailed blood and urine
analysis with radio imaging are must.
"Detailed history taking and clinical examination is
the key to early diagnosis. The mortality in AKI remains high
(10-19 per cent) with a five-year survival of severe AKI at 80
per cent," said Dr Ramesh Kumar, Senior Consultant
Nephrologist, Batra Hospital, located in Delhi.