Call for early detection of children's kidney problems

Call for early detection of children's kidney problems

JAKARTA (JP): Indonesia needs an early detection system for
kidney problems in children and an integrated medical program for
doctors, an expert in child nephrology said yesterday.

Husein Alatas, in his inauguration as professor at the
University of Indonesia's Medical Faculty, said that both
measures were more cost effective than the high price of
treatment for patients with advanced kidney problems.

Husein said that primary prevention would help stop healthy
children becoming ill and early and adequate treatment could
overcome kidney problems in children. He said this could happen
at public health centers and mother-child clinics.

He said kidney treatment was too expensive for most
Indonesians. Dialysis for children cost Rp 250,000 (US$96.15)
weekly, usually requiring two hospital visits.

Treatment could cost a young dialysis patient Rp 2 million
($770) a month, while those having Continuous Ambulatory
Peritoneal Dialysis (CAPD) could have to pay Rp 1.5 million
($576.92) a month, he said.

He said CAPD referred to a portable dialysis technique,
developed in 1976 by R.P. Popovich, which allowed a child with
chronic kidney failure to perform dialysis five times daily,
every four hours, with the help of a trained parent.

This dialysis technique enabled affected children to pursue
their schooling and other activities, he said.

He said a kidney transplant, from the donor transplant to
administering medication, cost Rp 20 million ($7,600).

Husein cited a long-term study of 30 children that showed that
children who had kidney transplants more than 10 years ago could
lead productive lives.

He said that 86 percent of the recipients were in good or very
good health, 43 percent were married and 77 percent either
worked, studied or did not work to care for their children.

Another report found that 70 percent were employed or working
independently, he said.

The quality of life for recipients increased in the long term
and they became productive workers, he said.

He said at a press conference that Indonesia would have to
compete with foreign doctors experienced in nephrology and deal
with a shortage of local medical specialists who knew about
nephrology, including for children.

Husein said there were still kidney transplant problems in
Indonesia because patients could not afford treatment or they
could not continue to rely on live kidney donors, which left a
child with the limited option of securing kidneys from parents or
other relatives.

He said transplanting kidneys from dead donors had not been
successful because of strong public opinion against surgery on
corpses, despite religious leaders' acceptance in 1995 of the
idea of transplanting kidneys from live and dead donors.

Law No. 23 of the 1992 Health Law allowed kidney transplants
from dead donors, but commercial organ donation was not allowed
and was illegal here but not in other countries, he said.

Kidney transplants in Indonesia had been performed on 227
adults since 1977, he said.

He cited a four-year-old study which ended in 1995 that showed
that 6.2 percent of children admitted to the state-owned Cipto
Mangunkusumo hospital were kidney patients, or 688 of the 11,162
children treated at the hospital. Kidney and urinary tract
problems were the leading kidney problems affecting children, he
said. (01)