Supporting children on dialysis
Posted on 29 August 2017
6-year-old Mpho* is on dialysis four times a week at the Morningside Children`s Kidney Treatment Centre at Mediclinic Morningside while he waits for a combined kidney and liver transplant. We find out more about Mpho, The KidneyBeanz Trust and how dialysis saves lives.
Together with The KidneyBeanz Trust, the Morningside Children`s Kidney Treatment Centre provides holistic care for children with severe and life-threatening kidney disease. An NPO founded in 2007 at Mediclinic Morningside by specialist paediatric nephrologist, Dr Errol Gottlich, The KidneyBeanz Trust now has fully equipped therapy rooms next to the centre, sponsored by Mediclinic. The Trust, also operating at the Charlotte Maxeke Academic Hospital, offers essential support services for children on dialysis through providing access to physiotherapists, occupational therapists, dieticians and psychologists who provide emotional support. The Trust also provides financial help for transport costs and pharmacy medical levies not covered by medical aid.
‘Because patients are on dialysis on most weekday mornings, they’re missing school,’ explains trust manager Megan Frye. ‘We provide an educator who keeps them up to date with school work or forms part of a home schooling programme. Once children have transplants they’re better able to reintegrate into a normal school routine.’
Creating a warm, colourful and stimulating environment, The KidneyBeanz Trust and Morningside Children`s Kidney Treatment Centre make a difficult treatment journey seem far less intimidating for both parents and children.
But what exactly does dialysis involve? ‘Dialysis is an artificial way of cleansing the body of toxins that are normally excreted in the urine,’ explains Dr Gottlich. ‘Dialysis can be done by connecting a patient to a blood dialysis machine (haemodialysis) usually for three four-hour sessions a week or it can be done through a tube inserted into the abdominal cavity – known as peritoneal dialysis. Peritoneal dialysis can be done intermittently during the day or can be done while the patient is asleep at night while connected to a machine.’
‘Machines that are involved in dialysis draw blood or peritoneal fluid containing the body toxins out of the patient and replace that fluid with a clean substitute fluid,’ he continues.
‘Certain patients on haemodialysis may feel weak at the end of the session due to the fluid shifts that occur during the dialysis session and the heart’s reaction to this. Thankfully modern dialysis techniques and treatments have minimised any discomfort that patients may feel while on therapy. Hopefully future medical research will enable artificial kidneys to be made from the patient’s own stem cells, allowing far better and quicker treatment to be initiated.’
‘Mpho, one of the children undergoing treatment at the centre, has a rare genetic condition called Primary Hyperoxaluria,’ explains Dr Gottlich. He was born with the condition but it only came to light when he was four and developed kidney stones. ‘In this condition, the liver doesn’t create enough of a certain protein (enzyme) that prevents overproduction of oxalate. Excess oxalate is eliminated through the kidneys and then into the urine. The extra oxalate combined with calcium to create kidney stones and crystals, which then damaged his kidneys and caused them to stop working – renal failure.’
Mpho needs to be on dialysis four times a week for three hours a session until he can undergo a combined liver and kidney transplant, once donor organs are available. ‘The liver transplant is necessary to ensure he has a normal amount of the enzyme required to metabolise oxalate to prevent a recurrence of the disease in the transplanted kidney.’
Tsida, Mpho’s mother, has to travel from the Vaal to the Morningside Mediclinic four times a week to ensure Mpho gets lifesaving treatment. She says after his kidney stones were removed, it was clear something was wrong. ‘He went from being a bubbly, talkative little boy to one who just wanted to sleep all day. Then he developed nosebleeds and doctors realised his kidneys had shut down. He’s been on dialysis for the last two months. When he’s on dialysis he sometimes plays with his toys or does his schoolwork with the educator, Shirley. Kidney Beanz has been a great support to us.’
Once donor organs are found, Mpho has a good prognosis. ‘Although he will face a 9-11 hour transplant operation and an approximate three-month long recovery, he and his parents are reassured that other patients at the Centre, who have undergone this procedure, have done so with very successful outcomes,’ says Dr Gottlich.
*Name has been changed.