The Role of the Government and Health Institutions related to Atypical Progressive Acute Kidney Failure (GGAPA) Cases

The Covid-19 pandemic is not over yet, and the public is shocked again by acute kidney failure cases in children. These cases have reached hundreds of more children, and several cases resulted in patient death.

Cases that attack children aged six months - 18 years have experienced an increasing trend in the last two months. As of October 18, 2022, a total of 189 cases have been reported, where the list of victims is dominated by children aged 1 to 5 years.

Parents are strongly advised to continue to monitor their child's health condition. If symptoms lead to Atypical Progressive Acute Kidney Failure (GGAPA), you should immediately consult a health professional.

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What is Atypical Progressive Acute Renal Failure (GGAPA)?

GGAPA is a condition of acute kidney injury in which there is a sudden or rapid decrease in the filtering function of that organ. This condition is characterized by increased serum creatinine concentrations or azotemia (increased urea nitrogen/BUN in the blood).

Sometime after experiencing the disturbance, creatinine or BUN may return to normal, so a sign that may appear new is a decrease in urine production. This is what parents need to watch out for.

So far, is generally not monitored what the condition of the child's urine is like. As one anticipation, parents need to ensure adequate fluids by drinking water. It is also necessary to pay attention to the administration of drugs when sick.

Based on information from various media, cases of kidney failure have increased in September 2022 due to Ethylene Glycol and Diethylene Glycol. The two compounds, also solvents, cause poisoning in the body.

This is related to the metabolism of ethylene glycol in the human body. However, the exact cause of acute kidney failure in children is not yet known, and observations and investigations are still being carried out by the team of doctors at Cipto Mangunkusumo Hospital and IDAI.

While waiting for the investigation results, parents are advised not to give syrup to their children. Several types of prohibited drugs have also been released by BPOM and coordinated with pharmacies and drugstores regarding their distribution.

Alternatively, if the child is sick, treatment can use other forms such as tablets, capsules, suppositories (anal), or others. You can also do basic treatment techniques such as compressing for fever, sunbathing, and drinking lots of water when you have a cold and cough.

Recognize the Symptoms

The initial symptoms that appear are related to gastrointestinal infections. Therefore the Ministry of Health urges parents to continue to ensure a clean and healthy lifestyle.

Clean and healthy living habits include washing hands regularly, eating a balanced nutritious diet, not snacking carelessly, drinking boiled water, and ensuring children get complete immunizations. In general, the symptoms of kidney failure that affect children are as follows:

1.   No Appetite

The child has no appetite, and increased urea levels in the blood cause even vomiting. This condition can be seen in the reduced need for children's favorite foods.

2. Pale

Damage to the kidneys causes a significant decrease in red blood cell production, and this causes anemia which then appears on the face.

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3.   Weak body

The buildup of urea in the blood causes the body to feel weak. Parents need to be vigilant if they find their child looks like they are tired even though they are not doing heavy physical activity.

4.   A lump appears in the stomach

The following symptom of kidney failure is the appearance of a lump in the abdomen. These lumps usually appear around the stomach or bladder, and this lump can be felt when touched.

5. Excessive Urine or No Exit at All

This feature is the easiest to recognize and is particularly concerning to parents. Urine can come out excessively or vice versa; it doesn't come out at all. You also need to watch out for red urine coming out.

6. Swelling in Several Parts of the Body

Swelling is caused by kidney function not working optimally. So that fluid accumulates in several body parts, which can be on the face or other factors.

Suppose parents find one or more of the above symptoms. In that case, they should immediately go to the nearest health facility for further examination, such as urine examination, kidney ultrasound, blood tests, and medical history.

Act of the Ministry of Health

Through the Ministry of Health, the government issued a Decree of the Director General of Health Services regarding the Management and Clinical Management of Atypical Progressive Acute Kidney Disease in Children.

The decision letter Number HK.02.02./2/I/3305/2022 contains references for the activities of medical personnel and other health workers in managing patients with acute kidney failure. From clinical diagnosis, further examination of kidney function is to determine etiological indications and complications.

Furthermore, intensive care will be carried out in the HCU / PICU if affirmed. The health facility will administer medication and monitor the patient's condition, including fluid volume balance and diuresis during treatment, awareness, Kussmaul breathing, blood pressure, and serial creatinine checks every 12 hours.

To increase awareness, synergy and collaboration of all parties are needed to prevent disease as early as possible. This was done by coordinating with the Health Service, hospitals, and state entry points to report any cases indicated immediately.

The Ministry of Health is also actively monitoring and tracking cases in the community. The goal is to find instances as early as possible. The community can also help report cases of acute kidney failure to the nearest health facility.

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Reviewed by:

dr. Harmeni Wijaya, MD

Corporate Communications

PT Bundamedik Tbk