By Kati Blocker
Twelve-year-old Amelia very likely could have been looking at emergency dialysis in her 20s. Because her chronic kidney disease was detected while she was still in middle school, Amelia has a fighting chance to keep her disease from progressing.
“This program probably saved this young lady from showing up in an emergency room at age 25, feeling terrible and being told that she has kidney disease and needs to start dialysis,” said Dr. Margaret Bock, a kidney specialist with Children’s Hospital Colorado, where Amelia is being treated.
Bock is talking about UCHealth Healthy Hearts, a 26-year-old program that screened about 7,000 Colorado students in 110 schools in Larimer and Weld counties during the 2017-18 school year. Healthy Hearts teams up with school districts’ health classes to provide heart health education to more than 12,000 kids annually. About 65 percent of these kids also participate in the program’s free cardiovascular school health screenings.
A screening for Amelia detected high blood pressure — generally rare in children, though concerning in a healthy and athletic preteen. The team of nurses followed up and called her mother, Kari.
The call was enough for Kari and her husband, Doug, to schedule an appointment with their family physician.
Amelia’s blood pressure reading with Healthy Hearts was 156/112. For children, the normal systolic range (top number) falls between 90 and 110.
“Her reading really stood out,” said NaNet Jenkins, manager of Healthy Hearts.
Numerous studies have shown that elevated blood pressure in childhood increases the risk for high blood pressure and other health issues in adulthood, according to the American Academy of Pediatrics (AAP). These kids also experience accelerated heart aging, which is the main reason why Healthy Hearts includes blood pressure in screenings.
Another reason is that high blood pressure — as with chronic kidney disease — usually has no symptoms.
“It was a good thing (Healthy Hearts) caught this,” Bock reiterated. “Now we can work to keep Amelia healthy. She knows what she has and can figure out what to do best to keep healthy.”
The kidneys — two fist-sized organs located on either side of the spine below the rib cage — serve as the body’s filtration system. They filter the body’s blood — either adding or removing water and chemicals based on the body’s need — and excrete that waste in the form of urine.
But they do a whole lot of things besides excrete urine, according to Bock.
“They also take care of growth in children, bone health, and making new red blood cells,” she said. “Amelia is not at the stage of disease where the kidneys are not filtering the blood (the process which dialysis mimics), but when kidney disease progresses it can also affect intellectual development.”
Kidney disease can result in high blood pressure, and high blood pressure can further damage the kidneys. In Amelia’s case, high blood pressure wasn’t the cause of her disease but a result of it.
Amelia’s cause of kidney disease was actually bilateral renal hypodysplasia, when a person is born with small kidneys, affecting how efficiently they function.
High blood pressure can further damage kidneys, so Bock is treating Amelia’s high blood pressure.
Since Amelia’s disease was caught early, doctors can be proactive in her treatment, Kari said.
“Her kidney function is about 35 percent, but when it drops under 28 to 30 percent, then we’ll need to start a preemptive kidney donor search,” she said. “If she can get a transplant before she hits stage 5 and needs dialysis, then I’m told her body takes better to the transplant.”
In the meantime, Amelia continues to be an active teenager. She’s dancing — something she’s been doing since she was 3 — and she went on a school trip to Ireland right after her diagnosis.
“She doesn’t like to talk about it, but we don’t downplay it because she’ll have to live with it the rest of her life,” Kari said. “She has to manage her health.”
Read the full story at: https://www.uchealth.org/today/2018/08/31/taking-heart-health-seriously-in-young-people/